Aims
To investigate the endâofâlife (EOL) nursing care practice process in longâterm care (LTC) settings for older adults in Japan.
Design
A qualitative study based on grounded theory developed by Corbin and Strauss.
Methods
Sampling, interviewing, and analysis were performed cyclically, with results for each stage used as the basis for data collection and nextâstage analysis decisions. Semiâstructured interviews were conducted from March 2015âMarch 2019 with 22 nurses from eight LTC settings. Analysis was performed using coding, constant comparison, and emerging categories.
Results
The core category, âguiding the rebuilt care community to assist the dying residentâ comprised five categories: âassessing the resident's stage,â âharmonizing care with the dying process,â ârebuilding a care community,â âhelping community members care for the resident,â and âencouraging community members to give meaning.â The participants were described as âtraditional village eldersâ who were the integral members of the care community, as well as guides who helped and encouraged the community.
Conclusion
Results revealed the holistic process of EOL nursingâcare practice in Japan. Nurses aimed to allow LTC residents to die as social human beings, surrounded by people, and not just responding physical and psychological distress. Such practice requires nursing expertise, healthcare skills, and leadership qualities to build and serve care communities. Nurses must also consider residentsâ uncertainties and vulnerabilities as well as their cultural backgrounds.
Impact
This study showed that the nurses hold unique roles in providing dying people with care from a community. These findings can potentially be applied for developing a universal model for LTC nurses in many aging populations, to modify their EOL care practice, educate new LTC nurses, and collaborate with other healthcare professionals.