Abstract
Background
"Dignity in death" (DiD) refers to avoiding suffering at the end-of-life by meeting individuals' physical, emotional, and spiritual needs compassionately and respectfully. This includes upholding autonomy, preserving individuality, and fostering open discussions about death while aligning care with the person’s values. Holistic care prioritises comfort and dignity, treating death with understanding rather than fear (Ignacio et al., 2016). However, little is known about how care home staff perceive "dignity in death," despite extensive research on hospital and hospice staff (Hemati et al., 2014; Matiti, 2002; Bovero et al., 2020). Care home residents primarily interact with care home workers, not healthcare professionals.
Objective
To explore care home staff perceptions of "dignity in death" in elderly palliative care.
Design
Interpretivist qualitative interview study.
Methods
Semi-structured online interviews with 11 participants from six privately funded West Midlands care homes analysed using reflexive thematic analysis.
Results
Autonomy was central to end-of-life care, with staff emphasising the need for individuals to live and die according to their wishes. Challenges arose when plans deviated, but maintaining individuality remained essential. Staff stressed treating residents as unique individuals, building emotional bonds like family relationships. Openness about death reduced fear and fostered understanding, while collaboration among staff ensured dignified care through an integrated approach.
Discussion
Dignity involves not only residents but also staff and families due to close relationships in care homes. This study highlights care home staff's pivotal role, which often overlooked in favour of clinical settings. Improved visibility, professional development, and formal end-of-life training are essential to address care demands, prevent burnout, and enhance care quality. Future research should explore dignity in diverse care contexts.
Conclusion
Recognition of care home staff's vital role in end-of-life care, alongside structured training in providing a dignified death, should be prioritised to ensure gold-standard care.
References
Bovero, A., Tosi, C., Botto, R., Pidinchedda, A., Gottardo, F., Asta, G. & Torta, R. (2022) A Qualitative Study to Explore Healthcare Providers’ Perspectives on End-of-Life Patients’ Dignity. How Can Dignity Be Defined, and Which Strategies Exist to Maintain Dignity? Journal of Cancer Education. 37 (2), 280–287. doi:10.1007/s13187-020-01808-z.
Hemati, Z., Ashouri, E., AllahBakhshian, M., Pourfarzad, Z., Shirani, F., Safazadeh, S., Ziyaei, M., Varzeshnejad, M., Hashemi, M. & Taleghani, F. (2016) Dying with dignity: a concept analysis. Journal of Clinical Nursing. 25 (9–10), 1218–1228. doi:10.1111/jocn.13143.
Maglio, I., Wierzba, S.M., Belli, L.F. & Somers, M.E. (2016) El derecho en los finales de la vida y el concepto de muerte digna. https://ri.conicet.gov.ar/handle/11336/39776.
Matiti, M.R. (2002) Patient dignity in nursing : a phemomenological study. doctoral. University of Huddersfield. https://eprints.hud.ac.uk/id/eprint/4599/, https://www.hud.ac.uk/news/.