The Residential Aged Care Facility Nurse’s Experiences in End-of-Life Care Delivery

Lili Gao

Background Literature suggests that there is a lack of skills and knowledge in end-of-life care among nurses working in residential aged care facilities globally, which can potentially have a negative impact on the quality of end-of-life care received by residents and their families. Purpose The purpose of this study was to explore aged care nurses’ lived experiences of providing EoL care to residents living in residential aged care and their families in WA with a focus on EoL conversations, ACP implementation, and perceived resources to support aged care nurses’ provision of EoL care and ACP for residents in RACFs. The research question was: What is the experience of aged care nurses providing EoL care to residents living in an RACF? The specific objectives were to: • • To explore and describe the meaning of providing EoL care from the perspectives of nurses working in an RACF setting. • • To describe nurses’ experiences of providing EoL with a focus on their conversations with residents and families. • • To explore nurses’ perspectives and experience of the ACP process and documentation in the context of their RACF setting. • • To identify nurses’ perspectives of resources to support aged care nurses to provide EoL care. Methodology The qualitative method of interpretative phenomenological analysis was used. Nurses from residential aged care facilities in Western Australia were recruited using purposive sampling. Semi-structured one-on-one interviews were audio recorded and transcribed verbatim for manual data analysis, guided by interpretative phenomenological analysis framework. Findings Eight nurses, including five registered nurses and three enrolled nurses participated. Four themes were generated from the data analysis described nurses’ experiences of: Complexity of EoL Care, Communication is Crucial in EoL Care, Sources of Support, and Education and Future Expectations. Nurses revealed that providing comfort was the priority goal of end-of-life care. Although feeling unprepared and potentially lacking confidence and skills in communication about end-of-life care and advanced care planning, providing care to residents and families at this time had personal meaning and value. Conclusion Findings from this study revealed that where possible, nurses working in residential aged care facilities employed innovative, compassionate, and holistic end-of life care to residents and families. However, challenges in end-of-life care provision were prominent, including nurses’ insufficient skills in recognising impending death, and their lack of confidence in end-of-life communication and advanced care planning. Overall, the findings from this study indicated that nurses recognised the importance of end-of-life care, but education was limited, and care quality would benefit from more focused and ongoing end-of-life education and support.

The Residential Aged Care Facility Nurse’s Experiences in End-of-Life Care Delivery

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