Background: There is a growing appreciation of long-term care residents’ needs for end-of-life care services as the number of elderly individuals grows. Therefore，understand the factors related to the provision of end of life care among nursing home staff is vital for making appropriate policies and provide enough resources for nursing home to ensuring a higher quality of life for dying residents.
Objective: This study examined the perceived facilitators and barriers to end-of-life care in care settings among nursing home staff.
Methods: A total of 367 participants (nurses: N=165; nurse aides: N=166) working at nursing homes in central Taiwan were enrolled in this cross-sectional study. The questionnaire of ‘Perceived Facilitators and Barriers to End-of-Life Care Scale’ was used. Data analysis was performed using SPSS21.0.
Results: (1) The top three perceived barriers items were ‘When the care staff for the residents, they also need to deal with distraught family members’, ‘Employing life sustaining measures at the families’ request even though the residents had signed advanced directives requesting no such treatment’, and ‘Intra-family fighting about whether to continue or stop life support‘. (2) The three highest-scoring facilitating items were ‘Consistency of care direction within care team’. ‘Providing a peaceful, dignified bedside scene for family members once the resident has died’, and ‘Teaching families how to act around the dying patient such as saying to them, She(he) can still hear . . . it is OK to talk to her(him)’.
Conclusion: Nursing home staffs still face many challenges while trying to provide quality end-of-life care. Family-related factors have the vital influences of providing end-of-life care in nursing home. In practice, family members should be provided space for privacy. The entire healthcare team is recommended to identify and pursue common values and objectives. In order to prepare care staffs for end of life situations in nursing home to reduce the barriers and ensure the quality of care, establishes a clinical strategy to satisfy family's need should be provided.
