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- Title
Decision-making in caring for people with dementia at the end of life in nursing homes.
- Authors
Koppitz, Andrea; Bosshard, Georg; Kipfer, Stephanie; Imhof, Lorenz
- Abstract
Background: Alleviating symptoms, fulfilling psychosocial needs, and the inclusion of family are among the criteria that determine care quality in palliative treatment. The care quality is especially inadequate for people with dementia (PwD) at the end of life. To improve this, it is necessary to understand the process of nurses' clinical decision-making in symptom management in the terminal phase of PwD. Aim: The aim of the study was to examine the decision-making process of symptom management for PwD in nursing homes in their terminal phase of life. Design: A qualitative design was chosen with a constructivist approach. Individual interviews were conducted with nurses (n=32) in four Swiss nursing homes. Results: 'Recount and reflect' plays a vital role in the care of PwD in terminal phase, enabling symptom recognition and facilitating symptom management. A process of thinking during the course of action enables nursing staff members to understand what, when, and how symptom changes have taken place. Conclusion: Highly-trained nurses need to support health care assistants through counselling, coaching, and leadership to help reduce the symptom burden experienced by PwD. Relatives are necessary to maintain an exchange of ideas regarding the appropriate treatment to reduce symptom burden.
- Subjects
SWITZERLAND; BEHAVIOR modification; CLINICAL competence; COMMUNICATION; DEMENTIA; GROUNDED theory; INTERVIEWING; LONG-term health care; LONGITUDINAL method; RESEARCH methodology; NURSING practice; NURSING assessment; NURSING home patients; NURSING care facilities; NURSING home employees; PALLIATIVE treatment; STATISTICAL sampling; TERMINALLY ill; DECISION making in clinical medicine; DATA analysis; SECONDARY analysis; NARRATIVES; EDUCATIONAL attainment; RETROSPECTIVE studies; DATA analysis software; WORK experience (Employment); DESCRIPTIVE statistics
- Publication
International Journal of Palliative Nursing, 2016, Vol 22, Issue 2, p68
- ISSN
1357-6321
- Publication type
Article
- DOI
10.12968/ijpn.2016.22.2.68