Nurses' Experiences of End of Life Care of Older Adults with Dementia

Chun-Gill Kim; Young Hee Lee

doi:10.7475/kjan.2017.29.2.119

Journal List > Korean J Adult Nurs > v.29(2) > 1076444

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim and Lee: Nurses' Experiences of End of Life Care of Older Adults with Dementia

Original Article

Korean Journal of Adult Nursing 2017; 29(2): 119-130.

Published online: 30 April 2017

DOI: https://doi.org/10.7475/kjan.2017.29.2.119

Nurses' Experiences of End of Life Care of Older Adults with Dementia

Chun-Gill Kim, Ph.D., RN¹, Young Hee Lee, Ph.D., RN²

¹Professor, Division of Nursing, Hallym University, Chuncheon, Korea.

²Professor, Department of Nursing, Catholic Kwandong University, Gangneung, Korea.

Corresponding author: Lee, Young Hee. Department of Nursing, Catholic Kwandong University, 24 Beomil-ro, 579beon-gil, Gangneung 25601, Korea. Tel: +82-33-649-7616, Fax: +82-33-649-7620, lyh@cku.ac.kr

Received 25 January 2017 Revised 22 March 2017 Accepted 19 April 2017

Abstract

Purpose

The purpose of this study was to understand the nurses' experiences of end of life care of older adults with dementia living in long-term care hospitals and geriatric care facilities.

Methods

The participants were nine nurses. Open in-depth interviews were used to collect data from June, 2016 to November, 2016. Colaizzi's phenomenological approach was used to analyze the data.

Results

Three categories were identified. The nurses' reported experiences of end of life care of older adults with dementia were ‘warm care with living together’, ‘care for family’, and the ‘self-reflection and responsibility as a nurse’. There were ten clusters of themes and 24 themes. The participants stated that the end of life care of older adults with dementia were individualized holistic care with dignity, being in older adults with dementia and family, and responsibility as a professional. Nurses reported the need for dementia hospice care.

Conclusion

These results could be considered in planning nursing intervention for hospice care. The findings support the need for educational strategies and programs to improve end of life care among older adults with dementia.

Keywords: Terminal care, Dementia, Aged, Qualitative research

Figures and Tables

Table 1

Themes, Theme Clusters and Categories of the Study

Notes

This research was supported by Hallym University Research Fund, 2016 (HRF-201606-012).

References

1. Cardoso A, Jolley D, Regan A, Tapley M. Dying with dementia: a challenge for palliative care now and in the future. Acta Med Port. 2014; 27(4):414–416.

2. Jones L, Candy B, Davis S, Elliott M, Gola A, Harrington J, et al. Development of a model for integrated care at the end of life in advanced dementia: a whole systems UK-wide approach. Palliat Med. 2016; 30(3):279–295. DOI: 10.1177/0269216315605447.

3. National Institute of Dementia. The status of dementia [internet]. cited 2017 February 8. Available from: https://www.nid.or.kr/info/today_list.aspx.

4. Statistics Korea. 2015 statistics of death cause [internet]. cited 2017 February 9. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board.

5. Edberg AK, Bird M, Richards DA, Woods R, Keeley P, Davis-Quarrell V. Strain in nursing care of people with dementia: nurses' experience in Australia, Sweden and United Kingdom. Aging Ment Health. 2008; 12(2):236–243. DOI: 10.1080/13607860701616374.

6. Alnes RE, Kirkevold M, Skovdahl K. Insights gained through Marte Meo counselling: experiences of nurses in dementia specific care units. Int J Older People Nurs. 2011; 6(2):123–132. DOI: 10.1111/j.1748-3743.2010.00229.x.

7. Sachs GA, Shega JW, Cox HD. Barriers to excellent end of life care for patients with dementia. J Gen Intern Med. 2004; 19(10):1057–1063.

8. Illiffe S, Davies N, Vernooij-Dassen M, van Riet Paap J, Sommerbakk R, Mariani E, et al. Modeling the landscape of palliative care for people with dementia: a European mixed methods study. BMC Palliat Care. 2013; 12(1):30. DOI: 10.1186/1472-684X-12-30.

9. National Law Information Center. Act on determination of lifesustaining medical treatment [internet]. cited 2017 January 11. Available from: http://www.law.go.kr/lsInfoP.do?lsiSeq=180823&efYd=20170804#0000.

10. Ryan T, Gardiner C, Bellamy G, Gott M, Ingleton C. Barriers and facilitators to the receipt of palliative care for people with dementia: the views of medical and nursing staff. Palliat Med. 2011; 26(7):879–886. DOI: 10.1177/0269216311423443.

11. Agar M, Beattie E, Luckett T, Phillips J, Luscombe G, Goodall S, et al. Pragmatic cluster randomized controlled trial of facilitated family case conferencing compared with usual care for improving end of life care and outcomes in nursing home residents with advanced dementia and their families: the IDEAL study protocol. BMC Palliat Care. 2015; 14(63):1–11. DOI: 10.1186/s12904-015-0061-8.

12. Mitchell SL, Kiely DK, Miller SC, Connor SR, Spence C, Teno JM. Hospice care for patients with dementia. J Pain Symptom Manage. 2007; 34(1):7–16. DOI: 10.1016/j.jpainsymman.2007.01.003.

13. Kim HS, Yu SJ. Pain assessment in nonverbal older adults with dementia. Korean J Hosp Palliat Care. 2013; 16(3):145–154.

14. Chambaere K, Cohen J, Robijn L, Bailey SK, Deliens L. End-oflife decisions in individuals dying with dementia in Belgium. J Am Geriatr Soc. 2015; 63(2):290–296. DOI: 10.1111/jgs.13255.

15. Davies N, Maio L, Rait G, Iliffe S. Quality end-of-life care for dementia: what have family carers told us so far? a narrative synthesis. Palliat Med. 2014; 28(7):919–930. DOI: 10.1177/0269216314526766.

16. Jayes RL, Arnold RM, Fromme EK. Does this dementia patient meet the prognosis eligibility requirements for hospice enrollment. J Pain Symptom Manage. 2012; 44(5):750–756. DOI: 10.1016/j.jpainsymman.2012.08.004.

17. Lim EK. Factors affecting the place of death of olders persons with dementia in Korea. [master's thesis]. Seoul: Seoul National University;2016. 51–58.

18. Kaasalainen S, Brazil K, Ploeg J, Martin LS. Nurses' perceptions around providing palliative care for long-term care residents with dementia. J Palliat Care. 2007; 23(3):173–180.

19. Kim MJ. A study on experiences of the care protect workers for caring the in-home elderly resident. [master's thesis]. Seosan: Hanseo University;2010. 40–43.

20. Colaizzi PE. Psychological research as the phenomenalist views it existential phenomenological alternative for psychology. New York: Oxford University Press;1978. p. 48–71.

21. Korean Association for Geriatric Psychiatry. The information of geriatric psychiatry [internet]. cited 2016 December 8. Available from: http://www.kagp.or.kr/caller/intro.html.

22. Guba EG, Lincoln YS. Effective evaluation: improving the usefulness of evaluation results through responsive and naturalistic approaches. San Francisco, Ca: Jossey-Bass;1981. p. 1–144.

23. Sloane PD, Zimmerman S, Williams CS, Hanson LC. Dying with dementia in long-term care. Gerontologist. 2008; 48(6):741–751.

24. Powers BA, Watson NM. Meaning and practice of palliative care for nursing home residents with dementia at end of life. Am J Alzheimers Dis Other Demen. 2008; 23(4):319–325. DOI: 10.1177/1533317508316682.

25. Robinson L, Dickinson C, Bamford C, Clark A, Hughes J, Exley C. A qualitative study: professionals' experiences of advance care planning in dementia and palliative care, 'a good idea in theory but …'. Palliat Med. 2013; 27(5):401–408. DOI: 10.1177/0269216312465651.

26. Kim TH, Park SH. The effects of internalizing behavior problems of patients with dementia in predicting family caregivers' burden, depressive and physical symptoms. Korean J Health Psychol. 2016; 21(1):65–89.

27. Yang HJ, Han SW. Burden of dementia patient's caregiver - Giorgi's phenomenological research methodology. J Soc Occup Ther Aged Dement. 2015; 9(2):1–9.

28. Song JA, Park JW, Kim HJ. Impact of behavioral and psychological symptoms of dementia on caregiver burden in nursing homes. J Korean Gerontol Nurs. 2013; 15(1):62–74.

29. Kim HJ, Kim HY. Experience of job stress among nurses working in long-term care hospital: a phenomenological approach. Korean J Adult Nurs. 2016; 28(5):572–584. DOI: 10.7475/kjan.2016.28.5.572.

TOOLS

Similar articles