A European multicenter study on systematic ethics work in nursing homes

Area of Science:

• Geriatric Care
• Bioethics
• Healthcare Management

Background:

• Nursing homes face persistent ethical challenges.
• Systematic ethics work is not yet standard practice in all facilities.
• Existing methods for addressing ethical issues require further integration.

Purpose of the Study:

• To explore ethical challenges in nursing homes.
• To investigate approaches for implementing systematic ethics work.
• To enhance ethical decision-making and resident care.

Main Methods:

• Mixed-methods approach across five institutions in Austria, Germany, and Norway.
• Documentation of 105 ethics meetings.
• Qualitative focus group interviews with staff on implementing systematic ethics work.

Main Results:

• Key topics included advance care planning, artificial nutrition, hospitalization, and end-of-life decisions.
• 76% of prospective case discussions reached agreement, though resident/relative participation varied.
• Staff reported increased openness, dialogue, and ethical awareness, with a need for administrative support.

Conclusions:

• Systematic ethics work is valued by staff and effective in reaching consensus.
• Implementation in all nursing homes is recommended, emphasizing everyday ethical issues.
• Improving participation of residents, relatives, and physicians is crucial for resident autonomy and dignity.