A qualitative study of family carers views on how end-of-life communication contributes to palliative-oriented care in nursing home

Background: Although family-centered communication about end-of-life care has been recognized to promote palliative-oriented care in nursing home (NH), how this communication may work is still unknown. Therefore, we explored the process by which end-of-life communication may contribute to palliative-oriented care in NH from the perspective of bereaved family carers.

Methods: A descriptive qualitative design was performed. Interviews were conducted with 32 bereaved family carers whose relative had died between 45 days to 9 months prior from 13 different NHs. A two-steps analysis process firstly with deductive and then with inductive content analysis was adopted.

Results: End-of-life communication contributed to palliative-oriented care by: a) improving knowledge of family carers’ preferences; b) promoting family carers understanding about their relative’s health conditions, prognosis, and treatment available; c) fostering shared decision-making between healthcare professionals and residents/family carers; and d) improving knowledge of residents’ preferences. 

Conclusion: Clear and in-depth communication provides insight into residents’ and family carers’ preferences for care and treatment at the end-of-life, and increases understanding and shared decision-making.