Abstract
BACKGROUND: Dying and death are inevitable occurrences in long-term care facilities where older, frail adults reside. The life satisfaction and well-being of older residents in the final stages of life are influenced by the nursing staff's perspectives on dying and death, their knowledge, and the quality of end-of-life care provided. This study explored the experiences and perspectives of nursing staff in long-term care facilities regarding end-of-life care for older residents. METHODS: The study adopted a qualitative design. Overall, 13 certified nurse assistants and 12 certified care workers who have worked in long-term care facilities for three months or more and possess experience in end-of-life care participated in this study. Data were collected from October 8, 2022, to January 18, 2023, through one-on-one in-depth interviews using semi-structured questions. The interview data were analyzed using MAXQDA 22 software (Berlin, Germany), following the procedure of qualitative content analysis. RESULTS: Three categories were identified in relation to the nursing staff's end-of-life care experiences and perspectives: "lack of personal preparedness," compassionate care for older residents at the end-of-life," and "neglected end-of-life care and the call for systemic improvements." CONCLUSIONS: Insufficient preparation of nursing staff, long-term care facilities, and policies for end-of-life care ultimately undermined the quality of life for older residents during their final years. Therefore, establishing institutional support and legal frameworks is necessary to ensure a dignified end-of-life environment. Developing a systematic and standardized end-of-life care manual should be a key research priority. Additionally, customized end-of-life care education programs should be designed and implemented to address the educational needs of nursing staff and enhance their practical competencies.