Factors that influence end-of-life care in nursing homes: the physical environment, inadequate staffing, and lack of supervision

Document Type

Article

Publication Date

2003

Abstract

This study investigated the physical environment and organizational factors that influenced the process of providing care to terminally ill nursing home residents.Design and Methods:Participant observation, interviews, and event analysis were used to obtain data in two proprietary facilities.Results:The physical environment was not conducive to end-of-life care. The rooms were crowded, there was little privacy, and the facilities were noisy. Inadequate staffing and lack of supervision were among the most significant organizational factors that influenced care. Often, residents did not receive basic care, such as bathing, oral hygiene, adequate food and fluids, and repositioning. A consequence of inadequate staffing was the development of pressure ulcers; 54% of the residents had pressure ulcers; 82% of these residents died with pressure ulcers.Implications:Findings suggest that the nursing home environment in these two facilities, as now structured, is an inappropriate setting for end-of-life care.

Comments

Copyright 2003 by The Gerontological Society of America, published by Oxford University Press

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Publication Title

The Gerontologist

Published Citation

Kayser-Jones, J., Schell, E., Lyons, W., Kris, A. E., Chan, J., & Beard, R. L. (2003). Factors that influence end-of-life care in nursing homes: the physical environment, inadequate staffing, and lack of supervision. The Gerontologist, 43(suppl_2), 76-84. doi:10.1093/geront/43.suppl_2.76.

DOI

10.1093/geront/43.suppl_2.76

Peer Reviewed

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