Death in long-term care facilities: Attitudes and reactions of patients and staff. A qualitative study

Abstract

Background Four-point-two percent of older Irish persons reside in extended-care facilities. Patients and staff in these settings frequently form close relationships, and the death of a patient can be a traumatic event. Despite this, resources and education in bereavement management have been lacking to date. Purpose We sought to investigate the effect of the death of such residents on patients and staff in a 320-bed, long-stay elderly care facility. Methods In-depth qualitative interviews were conducted within 24 hrs following the death of a resident. Seven patients and three staff took part. Patients with moderate or severe cognitive impairment were excluded. The interviews were audio-transcribed, and analysed for recurring themes. Results 9/10 interviewees were female. Patients’ age range was 70–90 years, staff 40–60 years. Participants described feelings of loss, inadequacy, and the desirability for patients and family to have privacy during the dying phase. We identified a four-stage model to describe the fellow patient grief reaction: (1) remembrance; (2) reflection; (3) religiosity and (4) relations. Conclusion Most participants in this study experienced a grief reaction following the death of a resident. This highlights the need for bereavement care programmes in elderly care units, to allow appropriate care and support to other long-stay residents and members of staff, in addition to grieving relatives.