Concordance of Family and Staff Member Reports about End of Life in Assisted Living and Nursing Homes

Autor/inn/en	Rich, Shayna E.; Williams, Christianna S.; Zimmerman, Sheryl
Titel	Concordance of Family and Staff Member Reports about End of Life in Assisted Living and Nursing Homes
Quelle	In: Gerontologist, 50 (2010) 1, S.112-120 (9 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0016-9013
DOI	10.1093/geront/gnp089
Schlagwörter	Residential Care; Familiarity; Death; Interaction; Nursing Homes; Decision Making; Caregiver Role; Caregivers; Family Role; Caregiver Attitudes; Family Attitudes; Interviews; Telephone Surveys; Health Services; Models; Expectation; Symptoms (Individual Disorders); Terminal Illness + Suchen Sie Ihr Suchwort? Sterbefall; Tod; Todesfall; Interaktion; Sonderheim; Decision-making; Entscheidungsfindung; Caregiver; Carer; Betreuungsperson; Pfleger; Interviewing; Interviewtechnik; Telephone interview; Telefoninterview; Health service; Gesundheitsdienst; Gesundheitswesen; Analogiemodell; Expectancy; Erwartung; Psychiatrische Symptomatik
Abstract	Purpose: To identify differences in perspectives that may complicate the process of joint decision making at the end of life, this study determined the agreement of family and staff perspectives about end-of-life experiences in nursing homes and residential care/assisted living communities and whether family and staff roles, involvement in care, and interaction are associated with such agreement. Design and Methods: This cross-sectional study examined agreement in 336 family-staff pairs of postdeath telephone interviews conducted as part of the Collaborative Studies of Long-Term Care. Eligible deaths occurred in or within 3 days of leaving one of a stratified random sample of 113 long-term care facilities in four states and after the resident had lived in the facility 15 days of the last month of life. McNemar p values and kappas were determined for each concordance variable, and mixed logistic models were run. Results: Chance-adjusted family-staff agreement was poor for expectation of death within weeks (66.9% agreement, [kappa] = 0.33), course of illness (62.9%, 0.18), symptom burden (59.6%, 0.18), and familiarity with resident's physician (59.2%, 0.05). Staff were more likely than family to expect death (70.2% vs 51.5%, p less than 0.001) and less likely to report low symptom burden (39.6% vs 46.6%, p = 0.07). Staff involvement in care related to concordance and perspectives of adult children were more similar to those of staff than were other types of family members. Implications: Family and staff perspectives about end-of-life experiences may differ substantially; efforts can be made to improve family-staff communication and interaction for joint decision making. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10