Paper
Saturday, November 3, 2007
50
End of Life Care Discourse in Nursing Homes
Nancy A. Hodgson, RN, PhD, CS, Madlyn and Leonard Abramson Center for Jewish Life, Polisher Research Institute, North Wales, PA, USA
| Learning Objective #1: discuss the barriers to palliative care identified by nursing home administrators, |
| Learning Objective #2: apply the use of a guided interview for communicating preferences on end of life preferences |
After years of denial, the experience of end of life care in the nursing home is beginning to enter the discourse of long-term care professionals. The demographic shift towards nursing homes as the place of death, the debate over long-term care reimbursements, and front-page stories about assisted suicide further fuel the debate on how best to transform the culture of dying and improve end of life care in nursing homes. Although it is important to identify those barriers that influence access to and utilization of palliative care services for nursing home residents it is equally important to understand how those barriers were constructed in the first place and what forces maintain them. In this paper we present the qualitative findings from the Palliative Care Services in Pennsylvania Nursing Homes (PCSPNH) Study. The purpose of this study was to identify and describe existing palliative care services within nursing homes in Pennsylvania and to identify the perceived barriers to palliative care in the nursing home setting. We question the assumptions underlying the language of palliative care discourse. In addition, we identify the challenges and potential solutions for raising the level of dialogue and discuss the implications for promoting communication strategies in meeting the death preferences of nursing home residents.
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