Aim To identify strategies that older adults use to adapt to live in long‐term care. Background The use of long‐term care services has risen and this trend is expected to continue as the population reaches old age. Moving into a long‐term care setting has been documented internationally as an overwhelming life change for many older adults. It has been observed that residents adjust differently over time, but the basis for these differences needs further exploration. Design A qualitative design using grounded theory method was employed. Methods A total of in‐depth interviews were conducted in October 2008–February 2009 with a sample of 21 participants. Participants ranged in age from 65–93 years, 81% women and 19% men; mainly Caucasian with one African American and one Hispanic. Length of stay ranged from 3 days to over 9 years living in long‐term care so that all stages of adjustment were included in the study. Ground theory method was used to analyse the data. Findings The results of this study yielded 21 facilitative strategies. The core category identified was personal resiliency, which served as the underpinning for the strategies used by the participants. Strategies were identified in making the decision to move into long‐term care and in day‐to‐day living. Conclusion Understanding the strategies that facilitate residents to make a successful transition to long‐term care life will assist nurses to intervene in ways that are supportive. The strategies identified in this study may be used to develop interventions for residents that are having difficulty living in long‐term care. Further exploration of how resiliency has an impact on strategies used by residents is clinically relevant, but further research is needed.
At least 1 in 5 Americans die while using intensive care service-a number that is expected to increase as society ages. Many of these deaths involve withholding or withdrawing life-sustaining therapies. In these situations, the role of intensive care nurses shifts from providing aggressive care to end-of-life care. While hospice and palliative care nurses typically receive specialized support to cope with death and dying, intensive care nurses usually do not receive this support. Understanding the experiences of intensive care nurses in providing care at the end of life is an important first step to improving terminal care in the intensive care unit (ICU). This phenomenological research study explores the experiences of intensive care nurses who provide terminal care in the ICU. The sample consisted of 18 registered nurses delivering terminal care in an ICU that participated in individual interviews and focus groups. Colaizzi's steps for data analysis were used to identify themes within the context of nursing. Three major themes consisted of (1) barriers to optimal care, (2) internal conflict, and (3) coping. Providing terminal care creates significant personal and professional struggles among ICU nurses.
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