[Behind each door you will find death: institutionalized dying]

Area of Science:

• Gerontology and Palliative Care
• Sociology of Aging and Healthcare

Background:

• Societal shifts increasingly institutionalize the care of elderly, frail, and impaired individuals.
• End-of-life care and discussions surrounding death and dying are often delegated to specialized professionals.

Purpose of the Study:

• To investigate the challenges and burdens associated with routine care for dying individuals in nursing homes.
• To identify staff attitudes towards discussing end-of-life issues with residents and their relatives.
• To explore strategies for enhancing the quality of dying within institutional settings.

Main Methods:

• Employed a mixed-methods approach combining qualitative interviews and quantitative surveys.
• Qualitative phase involved 17 nursing staff members to develop research questions.
• Quantitative phase surveyed 894 participants across 49 nursing homes, with data analyzed using descriptive and nonparametric methods.

Main Results:

• Nearly a quarter of staff found discussions about end-of-life with residents difficult.
• Approximately one-third of staff tended to avoid conversations about death and dying with relatives.
• A significant need for further interdisciplinary training in terminal care was identified.

Conclusions:

• Interdisciplinary collaboration with hospice volunteers, chaplains, psychologists, and caregivers is vital.
• Enhanced training and teamwork can improve the quality of end-of-life care in nursing homes.
• Addressing staff difficulties in end-of-life communication is essential for resident well-being.