Encountering nursing home residents' expressions of death and dying

BackgroundEncounters with nursing home residents often involve ethically sensitive situations involving fundamental values such as dignity, autonomy, and responding to existential suffering. Their everyday life in nursing homes is shaped by bodily decline, loss of independence, and social isolation, which may evoke reflections on death and dying. Such expressions frequently arise spontaneously in everyday care and may challenge health care professionals' moral sensitivity, and professional responsibility within organisational constraints. Prior research has explored such expressions but knowledge regarding how health care professionals engage in ethically sensitive conversations remains limited.AimTo describe healthcare professionals' experiences of encountering nursing home residents' expressions of death and dying.Research designA qualitative descriptive study was conducted using semi-structured interviews, which were analysed using inductive qualitative content analysis.Participants and research contextA total of 12 health care professionals - five assistant nurses, four registered nurses and three physicians - employed or consulting at nursing homes for older people.Ethical considerationEthical aspects were considered, and the study was approved by the Ethical Review Authority in Sweden (Dnr 2022-04026-01).ResultsWe identified four themes that emerged from the participants' response: Trying to find space and opportunity to talk about death and dying, Striving to understand what lies behind expressions of longing for death, Feeling emotionally attached, Navigating intertwined competences in encounters about death and dying.ConclusionThis study shows that conversations about death and dying in nursing homes often arise spontaneously in daily care and rely heavily on trusting relationships between residents in nursing homes and healthcare professionals. Such encounters require emotional presence, moral sensitivity and an ability to witness suffering rather than primarily attempting to solve it.