Family caregivers' experiences of end-of-life care in the acute hospital setting : A qualitative study

Abstract

Background: Acute hospital settings are generally not considered adequate places for end- of- life care, but terminally ill patients will continue to die in acute medical wards in the unforeseeable future. Aim: The aim of this study was to investigate family caregivers’ experiences of end- of- life care in an acute community hospital in Iceland. Methods: Fifteen in- depth qualitative semi- structured interviews were conducted with participants who had been primary caregivers. The transcribed interviews were analysed using thematic content analysis. Findings: Findings indicated that the acute hospital setting is not a suitable environ-ment for end- of- life care. Effective communication and management of symptoms characterised by warmth and security give a sense of resilience. Three main themes emerged: (1) Environmental influences on quality of care; (2) Communication in end- of- life care; (3) The dying process. Each of the themes encompassed a variety of subthemes. Conclusions: Findings suggest that effective communication is the cornerstone of quality of care in the acute hospital environment and essential for establishing a sense of security. The severity of symptoms can deeply affect family caregivers’ well- being. Acknowledging and appreciating the meaning of respect and dignity at the end- of- life from family caregivers’ perspective is vital.