Abstract
AIM: The aim of this study was to explore first-line nurse managers' perceptions of the challenges involved in decision-making concerning older patients who wish to die. DESIGN: A descriptive qualitative design in three communities in Norway between January 2016 and June 2016. METHODS: Qualitative focus group interviews with eight first-line nurse managers. RESULTS: One main theme and two themes were identified: Struggling to make the right decision, The challenge of social isolation and loneliness and When life becomes too painful and problematic. The sub-themes revealed that: Arranging social meeting places where the older patients can talk to other older people is crucial. The participants explained that it was not an easy task to gain an overview of the older patients situation. The right decision could be encouraging the patients to talk about their problems by giving them more time, thereby showing that somebody cares about them.