Developing and Implementing Peer-Led Intervention to Support Staff in Long-Term Care Homes Manage Grief

Jo-Ann Vis,Kristen Jones-Bonofiglio,Jessica Mcanulty,Katherine Kortes-Miller,Mary Lou Kelley,Kimberley Ramsbottom,Jill Marcella

doi:10.1177/2158244016665888

Abstract

Front-line staff in long-term care (LTC) homes often form strong emotional bonds with residents. When residents die, staffs’ grief often goes unattended, and may result in disenfranchised grief. The aim of this article is to develop, implement, and assess the benefits of a peer-led debriefing intervention to help staff manage their grief and provide LTC homes an organizational approach to support them. This research was nested within a 5-year participatory action research to develop and implement palliative care programs within four LTC homes in Canada. Data specific to this debriefing intervention included questionnaires from six peer debriefers, field observations of six debriefings, and qualitative interviews with 23 staff participants. An original peer-led debriefing intervention (INNPUT) for LTC home staff was developed and implemented. Data revealed that the intervention offered staff an opportunity to express grief in a safe context with others, an opportunity for closure and acknowledgment. The INNPUT intervention benefits staff and offers an innovative, sustainable, easy to use strategy for LTC homes.

Highlights

In the beginning of the session, the facilitator of the debriefing initiates the discussion concerning the resident’s death by first acknowledging the impact the death may have had on the staff
Due to the encompassing and time-consuming nature of their caregiving roles, the relationships that form between front-line staff and nursing home residents can be extremely close, and in some instances forged over years of providing intimate care (Anderson & Gaugler, 2006-2007)
It is essential for long-term care (LTC) homes to promote policies and practices that support a healthy grieving process for staff, and to implement innovative strategies to validate, enfranchise, and improve the process of working through the disenfranchised grief that direct care staff may experience after the death of LTC home residents

Summary

Background

The failure to acknowledge the relationships between staff and residents, and the denial of deaths in nursing homes, may preclude direct care staff from effectively moving through their grief process (Anderson & Gaugler, 2006-2007). Direct care staff, consisting of registered nurses (RNs), registered practical nurses (RPNs), and front-line staff (often referred to in the literature as personal support workers, health care aids, nurse’s aides, or nursing assistants) who work in LTC homes, can expect to experience the effects of loss and grief as a result of the death of residents for whom they have provided care. For the purposes of this article, the generic term unregulated care provider(s) (UCP) will be used to describe the front-line worker responsible for the majority of the resident’s daily health care needs

Objective

Research Method for Developing the INNPUT Intervention

I—Introduction

Conclusion