Nurses Assistants describe signs of dying among older people in a nursing home

Nurses Assistants describe signs of dying among older people in a nursing home

Life & Death Matters Post

In Sweden the Nurses Assistants provide much of the direct care, similar to Personal Support Workers (HCAs, CCAs etc.) in Canada. In this study they were interviewed and shared what they observed in the last days and hours before a person’s death. They identified clear physical changes as well as more subtle changes.
Recommendations include:

  • “Reports of signs observed by Assistant Nurses must be taken seriously,to increase the possibility of offering the best possible palliative care at nursing homes.
  • Assistant nurses must be seen as a significant part of the care team in order to take advantage of their practical knowledge.
  • Assistant nurses need to be offered continuous education and support regarding palliative care in order to develop their skills and practical knowledge.”

These recommendations are very appropriate for Canada as well. This past week I attended the Canadian Association of Continuing Care Educators (CACCE) conference in Vancouver. Discussions included the need to advocate for Health Care Workers to be recognized as significant contributors to the health care team, the need for Health Care Workers to open their mouth and provide input, and finally, discussion of ways to decrease the hierarchy in the health care team.

Discussion of Interprofessional Education may help to level the team, as people learn more about the role of the Health Care Workers.

Articles such as “Unsung Heroes” published by major newspapers in Ottawa, Vancouver, and others… will help people to see and talk about their contribution.

Celebrating and expressing gratitude are two simple ways that we can advocate and pay tribute to these workers.

Of course, the most important thing that the health care team can do is encourage Health Care Workers to observe, gather information and to share the information they received.

Finally, the last recommendation includes offering continuing education. And that of course is my  love and I hope that “Essentials in Hospice Palliative Care” a resource for Personal Support Workers” will be a great resource for students in the core curriculum, and for students working in clinical practice who want to learn! Keep on growing!


Reference: Assistant nurses’ descriptions of signs of dying among older people in nursing homes. Sahlberg-Blom, Eva; Hårsmar, Anna-Lena; Österlind, Jane; Nordic Journal of Nursing Research & Clinical Studies / Vård i Norden, 2013; 33 (3): 20-4. (journal article – research, tables/charts) ISSN: 0107-4083




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Courtney Murrell is a PSW who works in hospice palliative care.

When she is not at work, she is spending time with her family, going on hikes or writing. Courtney is a lifelong learner and loves to share her passion for writing as a wellness practice.

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