| Description |
With an increasingly older population in the United States, many older adults are expected to dwell in nursing homes (NHs)-a place where they may also experience the end of their life (EOL). Despite the growing number of older adults in NHs, meaningful discussions about preferences for end-of-life (EOL) care seldom occur between residents, NH staff, and / or residents' family members. The lack of communication results in missed opportunities to know, understand or implement residents' preferences. Missed conversations about EOL preferences have the potential to result in poor patient outcomes such as stress, fear and unnecessary pain during EOL. Me & My Wishes is a person-centered care approach where long-term care residents create videos. In their videos, residents tell us about themselves and the type of care they prefer. The videos are then shared with NH staff and family in the scheduled care conference meeting. For this qualitative content analysis, I analyzed 11 transcripts of 11 care conferences. Five transcripts were from care conferences prior to viewing the resident's Me & My Wishes video, and six were from care conferences when the video was shown. I identified codes a priori based on published literature and during an initial read-through of the transcripts, and then proceeded to code each transcript based on the identified codes with highlighting tools. During this process, more codes were identified and refined. Codes were next separated into corresponding categories, which were then defined, summarized and analyzed. Three objective questions relating to discussions surrounding resident preferences and person-centered care came from transcripts of care conferences before sharing the Me & My Wishes video as well as conferences that iii included the video and were used as a guide to analysis of the categories. Topics that were discussed during the care conferences included but were not limited to: resident history (i.e. medical and social history), preferences for current care (i.e. dietary, activity, medication and daily living), and preferences for EOL care (i.e. Physician Orders for Life-Sustaining Treatment forms). Based on excerpts from the care conferences and supporting literature, I developed recommendations for future care conferences relating to the integration of person-centered care. |
