Communicating With Nursing Home Residents About End of Life

Area of Science:

• Gerontology
• Palliative Care
• Healthcare Communication

Background:

• Many nursing home residents lack capacity for end-of-life (EOL) care discussions.
• A significant percentage of residents die within their first year.
• EOL care conversations are often delayed until residents are actively dying.

Purpose of the Study:

• To explore residents' perspectives on EOL communication in nursing homes.
• To identify strategies for facilitating EOL care discussions.
• To understand factors influencing EOL decision-making.

Main Methods:

• Secondary analysis of interviews with 46 participants (residents, family, staff).
• Data collected from a Southeast Florida nursing home (January-May 2019).
• Descriptive and pattern coding, matrices for thematic interpretation.

Main Results:

• Residents often assume their EOL preferences are understood by others.
• Past experiences with EOL or critical illness influence decisions.
• Residents and family members are willing to discuss EOL care.
• Nurses recognizing subtle decline can initiate EOL conversations.

Conclusions:

• Earlier EOL discussions are needed to support resident autonomy.
• Addressing assumptions about known preferences is crucial.
• Past experiences significantly shape EOL care choices.