Abstract
The number of elderly people dying in nursing homes is increasing in Japan. Nurses and other health care professionals must support the caregiving family members of dying residents in providing quality end-of-life care. However, little is known about family caregivers coping with bereavement. This study aimed to explore family caregivers' experiences with frail older adults living and dying in nursing homes. Two to 12 months after the death of elderly residents in three nursing homes in a provincial city, semi-structured interviews with family caregivers were conducted. These interviews were audiotaped, transcribed, and qualitatively analyzed using the phenomenological analysis method of Colaizzi. This study was approved by the Ethical Committee for Epidemiology of Hiroshima University. The participants included 15 family caregivers of 11 elderly nursing home residents. Six themes that characterized family caregivers' experiences with frail older adults living and dying in nursing homes were identified: (1) "Feeling of bonding with the resident," (2) "looking for care that can be provided by themselves," (3) "compromising with the staff and other residents," (4) "experiencing difficulties with decision making regarding medical procedures and the place of death for the loved one," (5) "coping with losing the loved one," and (6) "giving significance to the resident's life and end-of-life care." Nurses should understand the family caregivers' efforts and difficulties because of their feelings of bonding with the resident, and support the family caregivers so that they reflect on their caregiving experiences with a sense of satisfaction after the resident's death.
