2021 Volume 41 Pages 431-440
Aim: The present study aimed to clarify the framework for how expert nurses at acute care hospitals comprehend the intentions of oldest-old patients and their families and implement decision-making support with regard to the selection of care location of end-of-life care for oldest-old.
Method: Semi-structured interviews conducted on 10 participants were analyzed using qualitative synthesis method (KJ method).
Results: Expert nurses respected “the dignity of the person at the center of the decision about the selection of care location” from the perspectives of “seeking to understand the oldest-old” and “seeking to understand the family”. They understood the values and an experience of the oldest-old in order to provide “optimal medical care from the oldest-old perspective” and they made adjustments to determine “optimal medical care from the medical care providers’ perspective”. While protecting “the dignity of the person at the center of dependency on hospital medical care”, they provided “support for the feasibility of the desired location of care”. Based on the above results comprised the framework for decision-making support by expert nurses.
Conclusion: The present findings suggest that expert nurses take on the challenge of medical care for oldest-old while maintaining dignity for these patients.
