Difficulty in dealing with the end of life in long-term care units

Summary Working in geriatrics is physically and psychologically difficult but rewarding. In residential services, such as long-stay units, it also means working with death, because when you live in a facility, you die there. For the care teams, the difficulty also comes from the relationship they have with the medical team. This article is based on a research study and its aim is to talk about the conflicts, between doctors and the paramedical team, in geriatric long stay units. It aims to describe the vision of the different actors of the care on the end of life and its approach, but also on the conflicts which intervene during this care. The phenomenon is discussed from the point of view of the difficulties of working in these units, the vision of the professionals on the end of life, their vision of care in this situation and the conflicts that are present, the solutions to resolve them and the impact on the care of patients. The research is based on a central theme, which is based on the palliative care of elderly people at the end of life and the existing conflicts between the different actors. To this end, twenty-eight semi structured interviews were conducted with doctors, nurses and care assistants. The analysis shows that the conflicts between these three groups of carers who work with elderly patients at the end of life are caused by the doctors' actions bordering on unreasonable obstinacy, which generates a lack of understanding and anger among the paramedics. The solutions they use to remedy the situation are far from ideal and, above all, frustrating, as there is a resignation to a situation that will be repeated ad infinitum. This research work has highlighted the difficulties of caring for our elderly at the end of life in residential institutions and the unfailing involvement of paramedical and medical teams. (c) 2021 Published by Elsevier Masson SAS.