End-of-life care for elderly within aged residential care facilities : views and perceptions from their next-of-kin : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science with an Endorsement in Health Psychology at Massey University, Manawatu Campus, New Zealand
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Date
2015
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Massey University
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Abstract
By 2051, the number of people aged 65 and over will account
for 1.33 million of New Zealand’s population (Statistics New
Zealand, 2006). This has created attention as to what current
practices and facilities are available to this cohort of New
Zealand’s population, and what more we can do to make sure
we provide adequate services. Limited literature provides
insight into what takes place within aged-residential care
(ARC) facilities during end-of-life (EoL), especially within
New Zealand, even though approximately 40% of those aged
85 and above in New Zealand do already die in ARC
facilities (Gibb, 2014). This project investigates the
experiences and perceptions of EoL care for elderly within
ARC facilities, from the perspective of their next-of-kin
(NoK)/family member. Eleven NoK/family members who
experienced the passing of their elderly relative within an
ARC facility, were recruited as participants. The study used a
qualitative method with semi-structured interviews. The
interviews were then transcribed, and analysed using thematic
analysis on Dedoose, a web-based application, to draw
themes from the data. Questions were kept broad and open,
so that participants would be able to relay their story as
openly as possible without interruptions. The findings are
presented under ten major themes which includes; the
occurrence of a ‘crisis’ for their elderly relative, the
responsibility and adjustment to the role of NoK, changes in
the elderly relative’s personality, the effort and kindness
experienced within the ARC facility, reflection of the
conversations participants had with their elderly relative, the
multi-dimensional effect of pain, the process of letting go and
anticipatory grief, expectations of the ‘good death’, the
influence family has on the experience of being the
responsible NoK/family member, and the participants
experience of grief while managing the funeral. The
interpretation of the results highlighted the extended period
that is considered to be EoL and its care within an ARC
facility, as opposed to only the last few days before death.
This research enables an insight of what entails EoL care
within the environment of the ARC facility, as well as
allowing the NoK/family member to share the story of their
experience.
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Keywords
Older people, Nursing home care, Psychological aspects, Death