Silvia Gonella1,2, Ines Basso3, Maria Grazia De Marinis4, Sara Campagna3, Paola Di Giulio3. 1. 1 Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy. 2. 2 Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Turin, Corso Bramante 88-90, 10126 Turin, Italy. 3. 3 Department of Public Health and Pediatrics, University of Turin, via Santena 5 bis, 10126 Turin, Italy. 4. 4 Nursing Research Unit. University Campus Bio Medico of Rome, via Alvaro del Portillo 200, 00128 Rome, Italy.
Abstract
BACKGROUND: Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. AIM: To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual model of good end-of-life care according to the family perspective. DESIGN: Systematic review (PROSPERO no. 95581) with meta-aggregation method. DATA SOURCES: Five electronic databases were searched from inception between April and May 2018. Published qualitative studies (and mixed-method designs) of end-of-life care experience of nursing home family carers whose relative was dead or at the end-of-life were included. No language or temporal limits were applied. RESULTS: In all, 18 studies met inclusion criteria. A 'life crisis' often resulted in a changed need of care, and the transition towards palliative care was sustained by a 'patient-centered environment'. Family carers described good end-of-life care as providing resident basic care and spiritual support; recognizing and treating symptoms; assuring continuity in care; respecting resident's end-of-life wishes; offering environmental, emotional and psychosocial support; keeping family informed; promoting family understanding; and establishing a partnership with family carers by involving and guiding them in a shared decision-making. These elements improved the quality of end-of-life of both residents and their family, thus suggesting a common ground between good end-of-life care and palliative care. CONCLUSION: The findings provide a family-driven framework to guide a sensitive and compassionate transition towards palliative care in nursing home.
BACKGROUND: Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. AIM: To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual model of good end-of-life care according to the family perspective. DESIGN: Systematic review (PROSPERO no. 95581) with meta-aggregation method. DATA SOURCES: Five electronic databases were searched from inception between April and May 2018. Published qualitative studies (and mixed-method designs) of end-of-life care experience of nursing home family carers whose relative was dead or at the end-of-life were included. No language or temporal limits were applied. RESULTS: In all, 18 studies met inclusion criteria. A 'life crisis' often resulted in a changed need of care, and the transition towards palliative care was sustained by a 'patient-centered environment'. Family carers described good end-of-life care as providing resident basic care and spiritual support; recognizing and treating symptoms; assuring continuity in care; respecting resident's end-of-life wishes; offering environmental, emotional and psychosocial support; keeping family informed; promoting family understanding; and establishing a partnership with family carers by involving and guiding them in a shared decision-making. These elements improved the quality of end-of-life of both residents and their family, thus suggesting a common ground between good end-of-life care and palliative care. CONCLUSION: The findings provide a family-driven framework to guide a sensitive and compassionate transition towards palliative care in nursing home.
Entities:
Keywords:
Family; life change events; nursing homes; palliative care; qualitative research; systematic review; terminal care
Authors: Berivan Yildiz; Ida J Korfage; Erica Fe Witkamp; Anne Goossensen; Liza Gg van Lent; H Roeline Pasman; Bregje D Onwuteaka-Philipsen; Masha Zee; Agnes van der Heide Journal: Palliat Med Date: 2022-03-09 Impact factor: 4.762
Authors: Silvia Gonella; Paola Di Giulio; Alexandra Antal; Nicola Cornally; Peter Martin; Sara Campagna; Valerio Dimonte Journal: Int J Environ Res Public Health Date: 2022-02-22 Impact factor: 3.390