Nobody Wants to Talk About Dying: Facilitating End-of-Life Discussions

This educational study investigated the association between nursing staff and end-of-life discussions in an assisted living facility. Although mandated, these conversations often are deficient due to health care providers' limited knowledge on advance care documents.

All staff underwent end-of-life training to identify their own reservations that prevent involvement with advance directive completion, develop advance directive competency, recognize the ramifications when advance directives are not documented, and role-play to experience different character viewpoints.

The group discussions and interview data were summarized into four main themes: not qualified to broach the end-of-life documents; reluctance to get involved; right place, right time, and right words; and who wants to think about death? Eleven subthemes that detailed descriptions from each category also were identified.

Staff acknowledged the value of in-service education to alleviate their uncertainty on the subject matter, gaining confidence, proficiency, and perspectives with end-of-life planning. [.