Perspectives on Person-Centred End-of-Life Care in Care Homes: Findings From a Qualitative Secondary Analysis

Abstract

Background

The number of older people dying in long-term care facilities (LTCF) is growing globally. This highlights an urgent need for high-quality and person-centred palliative and end-of-life care (PEoLC) to be incorporated in LTCFs’, such as care homes. Resident health and care complexities can lead to challenges around PEoLC decision-making and delays in pre-death discussions, ultimately impacting on a care home’s ability to provide a ‘good death’ for the resident and those caring for them.

Aim

We aimed to explore what good person-centred end-of-life care might look like in a care home from the perspective of residents, family members and health and care professionals.

Design

A qualitative secondary analysis (QSA) of multistakeholder interview data collected from a multiple case study.

Methods

Sixty-one interviews were undertaken across seven care homes. Participants included care home residents, family members and health and care professionals. The data of these interviews were reanalysed by posing new questions; what might good person-centred end-of-life care (a ‘good death’) look like in a care home, and what factors influence its delivery? Data were analysed using reflexive thematic analysis (RTA).

Results

Three themes were generated from this QSA: Getting it right for the resident: ‘we only get one shot at it’; Supporting family members: ‘there till the end together’; and Caring for the care professionals: ‘I hate that part of my job’.

Conclusion

Good person-centred end-of-life care not only ‘gets it right’ for the resident by personalising moments spent with them during their last days and hours of life, but it also cares for their family and the care professionals delivering care. A people-centred approach to end-of-life care can guide future research and practice towards more responsive, setting-specific approaches that support a ‘good death’ in care homes.