"I didn't know it was going to be like this.": unprepared for end-of-Life care, the experiences of care aides care in long-term care.
Care aides
Dementia
End of life
Long-term care
Moral distress
Older adults
Palliative care
Qualitative research
Work satisfaction
Working conditions
Journal
BMC palliative care
ISSN: 1472-684X
Titre abrégé: BMC Palliat Care
Pays: England
ID NLM: 101088685
Informations de publication
Date de publication:
09 Sep 2023
09 Sep 2023
Historique:
received:
21
07
2022
accepted:
14
08
2023
medline:
11
9
2023
pubmed:
10
9
2023
entrez:
9
9
2023
Statut:
epublish
Résumé
Care aides provide up to 70-90% of the direct care for residents in long-term care (LTC) and thus hold great potential in improving residents' quality of life and end-of-life (EoL) care experiences. Although the scope and necessity of the care aide role is predicted to increase in the future, there is a lack of understanding around their perceptions and experiences of delivering EoL care in LTC settings. The aim of this study was to gain an understanding of the perspectives, experiences, and working conditions of care aides delivering end-of-life care in LTC in a rural setting, within a high-income country. Data were collected over ten months of fieldwork at one long-term care home in western Canada; semi-structured interviews (70 h) with 31 care aides; and observation (170 h). Data were analysed using Reflexive Thematic Analysis. Two themes were identified: (i) the emotional toll that delivering this care takes on the care aids and; (ii) the need for healing and support among this workforce. Findings show that the vast majority of care aides reported feeling unprepared for the delivery of the complex care work required for good EoL care. Findings indicate that there are no adequate resources available for care aides' to support the mental and emotional aspects of their role in the delivery of EoL care in LTC. Participants shared unique stories of their own self-care traditions to support their grief, processing and emotional healing. To facilitate the health and well-being of this essential workforce internationally, care aides need to have appropriate training and preparation for the complex care work required for good EoL care. It is essential that mechanisms in LTC become mandatory to support care aides' mental health and emotional well-being in this role. Implications for practice highlight the need for greater care and attention played on the part of the educational settings during their selection and acceptance process to train care aides to ensure they have previous experience and societal awareness of what care in LTC settings entails, especially regarding EoL experiences.
Sections du résumé
BACKGROUND
BACKGROUND
Care aides provide up to 70-90% of the direct care for residents in long-term care (LTC) and thus hold great potential in improving residents' quality of life and end-of-life (EoL) care experiences. Although the scope and necessity of the care aide role is predicted to increase in the future, there is a lack of understanding around their perceptions and experiences of delivering EoL care in LTC settings. The aim of this study was to gain an understanding of the perspectives, experiences, and working conditions of care aides delivering end-of-life care in LTC in a rural setting, within a high-income country.
METHODS
METHODS
Data were collected over ten months of fieldwork at one long-term care home in western Canada; semi-structured interviews (70 h) with 31 care aides; and observation (170 h). Data were analysed using Reflexive Thematic Analysis.
RESULTS
RESULTS
Two themes were identified: (i) the emotional toll that delivering this care takes on the care aids and; (ii) the need for healing and support among this workforce. Findings show that the vast majority of care aides reported feeling unprepared for the delivery of the complex care work required for good EoL care. Findings indicate that there are no adequate resources available for care aides' to support the mental and emotional aspects of their role in the delivery of EoL care in LTC. Participants shared unique stories of their own self-care traditions to support their grief, processing and emotional healing.
CONCLUSIONS
CONCLUSIONS
To facilitate the health and well-being of this essential workforce internationally, care aides need to have appropriate training and preparation for the complex care work required for good EoL care. It is essential that mechanisms in LTC become mandatory to support care aides' mental health and emotional well-being in this role. Implications for practice highlight the need for greater care and attention played on the part of the educational settings during their selection and acceptance process to train care aides to ensure they have previous experience and societal awareness of what care in LTC settings entails, especially regarding EoL experiences.
Identifiants
pubmed: 37689687
doi: 10.1186/s12904-023-01244-y
pii: 10.1186/s12904-023-01244-y
pmc: PMC10492357
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
132Subventions
Organisme : Canadian Frailty Network
ID : IFP 2014 SP - 03
Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Can J Aging. 2016 Sep;35(3):372-84
pubmed: 27452374
Can J Aging. 2019 Sep;38(3):268-280
pubmed: 30632479
Sociol Health Illn. 2021 May;43(4):995-1011
pubmed: 33885170
Can J Aging. 2019 Mar;38(1):35-50
pubmed: 30298797
Int J Older People Nurs. 2018 Sep;13(3):e12190
pubmed: 29575512
New Solut. 2019 May;29(1):10-35
pubmed: 30907683
Int J Nurs Stud. 2019 Jun;94:98-106
pubmed: 30951989
J Nurs Manag. 2022 Sep;30(6):1768-1776
pubmed: 35476219
J Am Med Dir Assoc. 2016 Jun 1;17(6):566.e1-7
pubmed: 27161314
Sociol Health Illn. 2015 Jan;37(1):112-26
pubmed: 25601068
J Holist Nurs. 2022 Jun;40(2):108-122
pubmed: 34048319
Gerontol Geriatr Educ. 2010;31(2):115-32
pubmed: 20509059
Can J Aging. 2012 Dec;31(4):411-21
pubmed: 23088799
Int J Nurs Stud. 2017 Jun;71:60-69
pubmed: 28334686
Death Stud. 2023;47(2):221-230
pubmed: 35275034
Palliat Med. 2019 Jun;33(6):589-606
pubmed: 30969160
Int J Older People Nurs. 2021 Mar;16(2):e12353
pubmed: 33124160
J Aging Stud. 2014 Aug;30:1-13
pubmed: 24984903
J Am Med Dir Assoc. 2021 Jan;22(1):199-203
pubmed: 33321076
BMC Palliat Care. 2019 Mar 7;18(1):26
pubmed: 30845931
J Gerontol Nurs. 2003 Mar;29(3):36-43
pubmed: 12683306
Omega (Westport). 2017 Jun;75(2):151-165
pubmed: 28490282
Gerontologist. 2008 Feb;48(1):16-24
pubmed: 18381828
J Clin Nurs. 2015 Oct;24(19-20):2815-25
pubmed: 26177787
Acta Biomed. 2018 Dec 07;89(7-S):60-69
pubmed: 30539935
Can J Aging. 2015 Mar;34(1):47-59
pubmed: 25525838
Palliat Med. 2019 Mar;33(3):274-290
pubmed: 30404576
BMC Nurs. 2015 Jul 22;14:38
pubmed: 26203297
Int J Qual Stud Health Well-being. 2014 Oct 16;9:26152
pubmed: 25326092
Health Soc Care Community. 2018 Jul;26(4):519-526
pubmed: 29462841
J Adv Nurs. 2021 Sep;77(9):3842-3852
pubmed: 34235778
Palliat Med. 2018 Feb;32(2):329-336
pubmed: 29017018
J Am Med Dir Assoc. 2014 May;15(5):307-8
pubmed: 24690490
Nurs Health Sci. 2020 Jun;22(2):343-354
pubmed: 31797527
Gerontologist. 2020 Feb 24;60(2):e105-e116
pubmed: 30977793
J Pain Symptom Manage. 2015 Jul;50(1):9-16
pubmed: 25701690
J Am Med Dir Assoc. 2010 May;11(4):246-52
pubmed: 20439043