2.50
Hdl Handle:
http://hdl.handle.net/10755/158328
Type:
Presentation
Title:
Family Reports of Dying Elders’ Symptoms and Care in Community Settings
Abstract:
Family Reports of Dying Elders’ Symptoms and Care in Community Settings
Conference Sponsor:Western Institute of Nursing
Conference Year:2004
Author:Cartwright, Juliana , RN, PhD
P.I. Institution Name:Oregon Health & Sciences University School of Nursing
Contact Address:, Ashland , OR, USA
Problem: Increasing numbers of older adults live their final days in assisted living (AL) and residential care (RC) facilities. Although these facilities admit and retain people with high levels of personal and health care needs, little is known about the end-of-life care experience in these settings. This pilot study (a) tested the psychometric properties of the Family Memorial Assessment Scale Global-Distress Index (FMSAS-GDI) with a sample of family members of older adults who died in AL and RC facilities, and (b) described family perceptions about the quality of symptom management and end-of-life care in these settings. Methods: In a retrospective descriptive design, 25 family members of people aged 65 and older, who had died two to four months earlier in AL or RC, were interviewed. The interview guide included the 11-item FMSAS-GDI, demographic questions, two close-ended items reporting family satisfaction with care, and two open-ended items asking families to describe how symptoms were managed and the quality of care provided. Families were recruited from 5 AL and 2 RC facilities in a mixed rural-urban region of the Northwest. The facilities were all proprietary, part of state or national corporations, and marketed themselves as places where older adults can age-in-place. Findings: The FMSAS-GDI demonstrated evidence for internal consistency reliability (a = .78) and concurrent validity (r = .58; p = .01) when comparing the mean FMSAS score with a single item rating the decedent’s overall level of comfort in their last week of life. Seventy percent of family members reported that the decedent experienced the following symptoms in their final week of life: lack of energy, drowsiness, dry mouth, and pain. Symptoms that family members thought caused the greatest distress included pain, difficulty breathing, constipation, lack of energy, and dry mouth. On the quantitative satisfaction questions, 14 (56%) families were very satisfied overall with symptom management, and only 1 (7%) was not satisfied. Sixteen families (64%) were very satisfied with quality of care at EOL, and 2 (8%) were not satisfied. All families supported the elder’s desire to die in their AL or RC ‘home.’ Frequently expressed were concerns about the lack of communication and coordination of care between hospice or home health and facility staffs. Conclusions: Preliminary psychometric evidence suggests the scale may be appropriate for use in studies of symptom experiences at EOL in AL and RC. The extent and types of symptoms reported and the family concerns expressed around communication and coordination of care support the need for further research about end-of-life symptoms and their management in community care facilities. Funded as a subproject supported by the National Institute of Nursing Research Exploratory Nursing Research Center Grant 1P20NR07807-01 awarded to Lillian Nail.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleFamily Reports of Dying Elders’ Symptoms and Care in Community Settingsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158328-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Family Reports of Dying Elders&rsquo; Symptoms and Care in Community Settings</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cartwright, Juliana , RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Sciences University School of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Ashland , OR, USA</td></tr><tr><td colspan="2" class="item-abstract">Problem: Increasing numbers of older adults live their final days in assisted living (AL) and residential care (RC) facilities. Although these facilities admit and retain people with high levels of personal and health care needs, little is known about the end-of-life care experience in these settings. This pilot study (a) tested the psychometric properties of the Family Memorial Assessment Scale Global-Distress Index (FMSAS-GDI) with a sample of family members of older adults who died in AL and RC facilities, and (b) described family perceptions about the quality of symptom management and end-of-life care in these settings. Methods: In a retrospective descriptive design, 25 family members of people aged 65 and older, who had died two to four months earlier in AL or RC, were interviewed. The interview guide included the 11-item FMSAS-GDI, demographic questions, two close-ended items reporting family satisfaction with care, and two open-ended items asking families to describe how symptoms were managed and the quality of care provided. Families were recruited from 5 AL and 2 RC facilities in a mixed rural-urban region of the Northwest. The facilities were all proprietary, part of state or national corporations, and marketed themselves as places where older adults can age-in-place. Findings: The FMSAS-GDI demonstrated evidence for internal consistency reliability (a = .78) and concurrent validity (r = .58; p = .01) when comparing the mean FMSAS score with a single item rating the decedent&rsquo;s overall level of comfort in their last week of life. Seventy percent of family members reported that the decedent experienced the following symptoms in their final week of life: lack of energy, drowsiness, dry mouth, and pain. Symptoms that family members thought caused the greatest distress included pain, difficulty breathing, constipation, lack of energy, and dry mouth. On the quantitative satisfaction questions, 14 (56%) families were very satisfied overall with symptom management, and only 1 (7%) was not satisfied. Sixteen families (64%) were very satisfied with quality of care at EOL, and 2 (8%) were not satisfied. All families supported the elder&rsquo;s desire to die in their AL or RC &lsquo;home.&rsquo; Frequently expressed were concerns about the lack of communication and coordination of care between hospice or home health and facility staffs. Conclusions: Preliminary psychometric evidence suggests the scale may be appropriate for use in studies of symptom experiences at EOL in AL and RC. The extent and types of symptoms reported and the family concerns expressed around communication and coordination of care support the need for further research about end-of-life symptoms and their management in community care facilities. Funded as a subproject supported by the National Institute of Nursing Research Exploratory Nursing Research Center Grant 1P20NR07807-01 awarded to Lillian Nail. </td></tr></table>en_GB
dc.date.available2011-10-26T20:44:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:44:13Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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