Quality of Dying Among Institutionalised Nursing Home Residents From the Caregivers' Perspective: A Mixed-Methods Study.
Daniel Puente-Fernandez, Emilio Mota-Romero, Manuel Fernández-Alcántara and 3 others
PMID 40716029WHAT IT FOUND
Family caregivers rated nursing home end-of-life care as generally acceptable, with good symptom control and personal care, but closure and final practical matters were weaker, especially when residents had cognitive impairment.
Key findings
01Family caregivers gave a mean global rating of 3.34 on a 1 to 5 scale and a mean QoD-LTC score of 39.29 on an 11 to 55 scale.
02Pain, hygiene, affection, dignity and staff relationships were rated high by most caregivers, while closure and preparatory tasks were rated lower.
03Residents with cognitive impairment were rated lower on the total QoD-LTC, closure and preparatory tasks than residents without, while the single-item global rating did not show the same difference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 69 of 110 potential family caregivers completed the questionnaire, and just 11 took part in interviews, so the qualitative findings come from a small self-selected group. The questionnaire was completed 3 to 4 months after the resident died, so memory and grief may have shaped the ratings. The study did not know why 12 caregivers could not be contacted or why 8 declined to participate. Some clusters of high or low questionnaire scores had no matching interview explanations, so the mixed-methods comparison was incomplete for those items. The work was done in Spanish nursing homes, so cultural attitudes to death and family decision-making may limit how far it transfers elsewhere.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read the generally acceptable global rating as proof that all end-of-life care was good. Closure and preparatory tasks were rated lower, and families sometimes treated silence, cognitive impairment or lack of objection as agreement.