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Nurse assistants' perception of caring for older persons who are dying in their own home: An interview study.
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0003-4395-2522
Department of Health and Social Care, Home Care Kungsparken, Malmö Municipality, Västra Kanalgatan 4, Malmö 211 41, Sweden.
3 Department of Health and Social Care, Malmö Municipality, Villa Vikhem, Vikhems bygata 100, Staffanstorp 245 46, Sweden.
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0002-6114-6535
2024 (English)In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 23, no 1, article id 70Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: As the proportion of older persons in society increases, there is a growing trend towards providing end-of-life care in their homes. Palliative care is a complex and knowledge-demanding form of care, and nurse assistants are those who work closest to the older person at the end-of-life in their own homes. However, nurse assistants sometimes have low educational and insufficient levels of knowledge in palliative care, which can affect the quality of care they provide. Moreover, nurse assistants' experiences are relatively unexplored in this context. The purpose of the study was to illuminate nurse assistants' experiences in caring for dying older persons at home.

METHOD: An empirical, qualitative interview study was conducted with 14 nurse assistants with experience of palliative care in homecare. The material was analyzed using thematic content analysis.

RESULTS: From the nurse assistant's experiences, one main theme emerged: doing everything possible for the dying older person despite challenges. Moreover, three sub-themes emerged: making a difference at a crucial time, death awakens emotions, and balancing personal and professional relationships. The nurse assistants' saw their role primarily as relieving symptoms but also focusing on next of kin. The following are described as essential parts of their role: carrying out practical nursing tasks, focusing on the physical environment, working alone and seeking help from colleagues due to a physical distance to the other members of the multidisciplinary team. The nurse assistants experienced a lack of support as there was no structured guidance or debriefing available in difficult emotional situations. Furthermore, they disclosed that they were left alone to deal with their feelings.

CONCLUSION: This study demonstrates that nurse assistants strive to provide comprehensive care for dying older persons despite facing obstacles from their working conditions and work organization. They lack supervision and education in palliative care, but they rely on their experience-based knowledge to a large extent and provide care according to the four cornerstones of palliative care.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024. Vol. 23, no 1, article id 70
Keywords [en]
Home care, Interview study, Nurse assistant, Older person, Palliative care
National Category
Nursing
Identifiers
URN: urn:nbn:se:mau:diva-66556DOI: 10.1186/s12904-024-01399-2ISI: 001182118700001PubMedID: 38468298Scopus ID: 2-s2.0-85187456321OAI: oai:DiVA.org:mau-66556DiVA, id: diva2:1847714
Available from: 2024-03-28 Created: 2024-03-28 Last updated: 2024-03-28Bibliographically approved

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Annersten Gershater, MagdalenaHommel, Ami

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