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Taking care of family members of a dying client in a home for the eldelrly.
ZIMOVÁ, Eva
People usually die in hospitals, at subsequent care departments and in retirement homes nowadays. Ill people die alone outside the comfort of their homes and in the care of professionals, who are strangers for them. Dying has become an institutionalized process. Dying is first of all a process that consists of three known periods of different length, which are linked together the pre finem, in finem and post finem periods. They are described in chapter 2. Chapter 3 describes the mental response stages according to Elisabeth Kübler-Ross in the usual order as the mostly occur. The fourth chapter mentions the needs of the dying and the role of a nurse in their satisfaction. Communication with family members is probably the most demanding activity for a nurse. Communication and its principles is dealt with by the fifth chapter. The sixth chapter describes the phases of grief according to Kubíčková (2001), but also the uncomplicated and complicated grief. The assistance to the family is described in the seventh chapter. A subchapter is also dedicated to counselling for the bereaved.The load on nurses in relation to dying is mentioned at the end of chapter eight. The last, ninth chapter describes a retirement home and the services it provides. The first goal was to examine the readiness of healthcare staff to communicate with the family members of dying clients. The second goal was to find the spheres in which the family members of a dying client need advice. The third goal was to examine the services provided to the family members of a dying client by a retirement home. The research questions:How are general nurses able to cope with communication with the family of a dying patient?What topics do general nurses avoid in communication with the family of a dying patient?What advice are general nurses able to give to the bereaved?What possibilities do retirement homes have to ensure dying with dignity?What services do retirement homes provide?Qualitative research in the form of semi structured interviews was chosen for elaboration of the empiric part of the thesis. The interviews were based on prepared questions and sub questions for general nurses from two retirement homes. One of them is in the South Bohemia Region and the other in the Central Bohemia Region. The sample consisted of eight general nurses. The interviews were recorded in written and then processed into individual categories. The names of the facilities are not mentioned to ensure anonymity. The thesis gives an insight into two addressed retirement homes in different regions. The research has brought the view on the care of family members and valuable comparison of the provided services and the possibilities of the homes. Communication with the family is in some situations unpleasant and stressing for a nurse, however it is frequent and inevitable. The research shows that informing of worsened state and client's death is most unpleasant and stressing. General nurses should be better aware of the phases of dying according to Elisabeth Kübler-Ross and they should realize that the family members go through the same phases. We have also found that if family members are not offered assistance and support, they usually do not ask for it. Both the homes are trying to create the environment for dying with dignity according to their possibilities. They offer unlimited visits, spiritual services and also the possibility of the last goodbye, however it is not offered automatically. The choice of funeral service is on the other hand always offered at the death notification.There are differences between the two homes in the environment where the care of the death body is taken, where the last goodbye is held and the inheritance passed. One home has the possibility to care about the deceased in a dedicated room, where also the last goodbye and inheritance passing is held. The other home does not have this possibility.
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