Death in long-term care facilities: Attitudes and reactions of patients and staff. A qualitative study

Background: Four-point-two percent of older Irish persons reside in extended-care facilities. Patients and staff in these settings frequently form close relationships, and the death of a patient can be a traumatic event. Despite this, resources and education in bereavement management have been lacking to date. Purpose: We sought to investigate the effect of the death of such residents on patients and staff in a 320-bed, long-stay elderly care facility. Methods: In-depth qualitative interviews were conducted within 24 hrs following the death of a resident. Seven patients and three staff took part. Patients with moderate or severe cognitive impairment were excluded. The interviews were audio-transcribed, and analysed for recurring themes. Results: 9/10 interviewees were female. Patients' age range was 70-90 years, staff 40-60 years. Participants described feelings of loss, inadequacy, and the desirability for patients and family to have privacy during the dying phase. We identified a four-stage model to describe the fellow patient grief reaction: (1) remembrance; (2) reflection; (3) religiosity and (4) relations. Conclusion: Most participants in this study experienced a grief reaction following the death of a resident. This highlights the need for bereavement care programmes in elderly care units, to allow appropriate care and support to other long-stay residents and members of staff, in addition to grieving relatives. (C) 2010 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.