Journal of Nursing & Care

A Qualitative Study of Long-term Care Leaders’ Experiences of End-of-Life Care Provision at Long-term Care Facilities in Japan

Abstract

Yoshihisa Hirakawa and Kazumasa Uemura

Several studies have highlighted the fact that long-term care facilities and caring staff are not ready for quality endof- life care provision. The present study is aimed at shedding light on how caring staff provide care at the end of life and the emotions they experience in the provision of this care. Study participants were 4 long-term care leaders from different long-term care facilities. The subject for focus group discussion was end-of-life care at long-term care facilities. We used the KJ method (Kawakita Jiro’s initials) as a qualitative research tool, which is widely employed in Japan. The emotions and experiences were organized into 9 groups (including 2 loner labels): 1) Active family involvement is important to successful end-of-life care; 2 Caring staff want to provide end-of-life care with compassion as well as logic; 3 Caring staff would rather avoid facing death or dealing with dying residents; 4 Caring staff are at a loss as to how to behave around the time of a resident’s death; 5) There are language and psychological communication barriers among members of the end-of-life care team; 6) Caring staff get used to death through repetition; 7) End-of-life care for the elderly is challenging work. The loner labels were “A person who can remain calm and collected when facing the death of a resident” and “There are no complete manuals on providing end-of-life care due to the diversity in dying processes of elderly residents”.

The present study reveals that long-term care leaders require a person who is able to remain composed in a demanding and emotional end-of-life care environment. Also, they thought that such a cool-headed person is best suited to tend to the needs of caring staff and residents’ family and to promote communication among end-of-life care team.