Nursing Home Staff Perceptions of End-of-Life Care for Residents With Advanced Dementia: A Multisite Qualitative Study.
Harriet S Akunor, Ellen P McCarthy, Meghan Hendricksen and 4 others
PMID 35195109WHAT IT FOUND
Nursing home staff preferred residents with advanced dementia to die in the nursing home.
Hospice views were mixed, with some seeing added support and others seeing duplication or interference. Staff also described grief.
Key findings
01Almost all nursing home staff preferred residents with advanced dementia to spend their last days in the nursing home rather than being transferred to hospital.
02Staff perceptions of outside hospice were mixed: some saw added care and support, while others saw duplicative and disruptive care.
03Staff across roles described grief, sadness, and emotional strain from caring for dying residents; nurses and CNAs described these emotions more poignantly.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study asked staff, not residents or families, so it cannot show what patients or families experienced. Hospice perceptions were secondary themes from interviews not originally focused on hospice. Qualitative methods can describe themes but cannot show that hospice or nursing home care causes better outcomes. The sample was limited to selected nursing homes in multiple states, so it may not apply elsewhere. Data were collected before the pandemic, so current nursing home end-of-life experiences may differ.
Declared interests
The authors reported no known conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not read staff preferences or hospice perceptions as evidence that hospice improves resident outcomes. The study reports what staff said, not patient results.