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Healthcare 2018, 6(2), 63; https://doi.org/10.3390/healthcare6020063

Conversations about Death and Dying with Older People: An Ethnographic Study in Nursing Homes

1
Department of Social Work, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
2
Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00 Lund, Sweden
3
Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, SE-581 83 Linköping, Sweden
4
Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, SE-351 95 Växjö, Sweden
5
The Institute for Palliative Care, Region Skane and Lund University, P.O. Box 157, SE-221 00 Lund, Sweden
*
Author to whom correspondence should be addressed.
Received: 12 May 2018 / Revised: 11 June 2018 / Accepted: 12 June 2018 / Published: 14 June 2018
(This article belongs to the Special Issue Recent Advances in Palliative Care)
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Abstract

Nursing homes are often places where older persons “come to die.” Despite this, death and dying are seldom articulated or talked about. The aim of this study was to explore assistant nurses’ experiences of conversations about death and dying with nursing home residents. This study is part of an implementation project through a knowledge-based educational intervention based on palliative care principles. An ethnographic study design was applied in seven nursing homes, where eight assistant nurses were interviewed and followed in their daily assignments through participant observations. The assistant nurses stated that they had the knowledge and tools to conduct such conversations, even though they lacked the time and felt that emotional strain could be a hinder for conversations about death and dying. The assistant nurses used the strategies of distracting, comforting, and disregarding either when they perceived that residents’ reflections on death and dying were part of their illness and disease or when there was a lack of alignment between the residents’ contemplations and the concept of dying well. They indicated that ambivalence and ambiguity toward conversations about death and dying should be taken into consideration in future implementations of knowledge-based palliative care that take place in nursing homes after this project is finalized. View Full-Text
Keywords: auxiliary nurse; existential communication; frailty; ethnographic approach; life-limiting disease; older; aged; palliative care; residential care; end-of-life auxiliary nurse; existential communication; frailty; ethnographic approach; life-limiting disease; older; aged; palliative care; residential care; end-of-life
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Alftberg, Å.; Ahlström, G.; Nilsen, P.; Behm, L.; Sandgren, A.; Benzein, E.; Wallerstedt, B.; Rasmussen, B.H. Conversations about Death and Dying with Older People: An Ethnographic Study in Nursing Homes. Healthcare 2018, 6, 63.

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