Death in the nursing home - the patient's wishes and the physician's role

What we do

This was Anette Fosses Ph.D. project. Supervisors were Margrethe Aase Schaufel, Sabine Ruths and Kirsti Malterud. Anette Fosse defended her theses at the University of Bergen 14.06.18. The thesis can be downloaded here

Nursing homes are the main setting for dying in Norway. How can doctors contribute to quality of end of life care in nursing homes for patients and families? Three sub-studies shed light on the following issues:

  • Patients’ and families’ experiences and expectations
  • Nursing homes as learning arena for new doctors
  • Conditions for end-of-life care in in nursing homes in Norway and the NetherlandsThe patient's wishes
  • We conducted a meta-analysis of qualitative research on patients' and relatives' experiences and expectations. Death can be safe and dignified if doctors provide expert guidance and are aware of the preferences of the patient and family. One paper is published.

Nursing homes as learning arena

We carried out 3 focus group interviews with interns in nursing homes to explore their learning experiences and challenges in the face of death. Such knowledge can help develop nursing homes as a venue to empower medical graduates in performing high quality end-of-life care. One paper is published.

Conditions for medical end-of-life care in nursing homes

In collaboration with the University of Groningen, the Netherlands, we have performed an anonymous, descriptive, comparative, electronic survey among nurdin home doctors in Norway and The Netherlands. We explored nursing home physicians’ perceptions of organizational, educational, financial, legal and personal prerequisites for quality end-of-life care. One paper is submitted.

Overall, the ph.d project provided new insights into how nursing home doctors can enhance the quality of end-of-life care, based on the expectations from patients and their families.

Updated: 21.09.2018

Project outcomes

  • Dying in nursing homes can be safe and dignified when doctors provide guidance, treatment and medical care based on professional skills, combined with awareness of the preferences of patient and family
  • Nursing home patients and their relatives wanted doctors more involved in end-of-life care.
  • Special attention must be drawn on patients’ competence to give consent. Nursing homes as practice-based learning arena can offer newly qualified doctors new insight in their role as doctors through close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.