Decision making and care providing process： The experience of providing accompany for a relative’s the end of life process in a long-term care facility.

• Main Authors: Huang, Chia-Hui, 黃佳慧
• Other Authors: Chen, Yu-Hsien
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/3f94nq

碩士 === 慈濟科技大學 === 長期照護研究所 === 107 === With the development of medical science and technology and the transformation of social industry patterns, both the fertility rate and the death rate have declined in Taiwan. The demographic structure tends to be aging, and the demand for long-term care continues to increase. In recent years, the proportion and the number of disabled people receiving care in long-term care facilities have also increased. With the advancement of patient’s autonomy and right of advanced care planning, more and more people have chosen to keep staying in the long-term care facilities in the end of their lives. Although the number of clients who receiving hospice and palliative care in long-term care facilities has increased year by year, there is still no adequate principles that can be followed for the end-of-life care and for family care in long-term care facility. Little is known about the family members’ experiences of taking care of the relative who is closed to the end of life in long-term care facilities. The purpose of this research is to provide theoretical understandings of the experiences, meanings, and interpretations of family members who providing accompany and care for their frail relatives to pass the last minutes of the rest of lives in long-term care facilities. Symbolic interactionism was used to guide this qualitative research process and Kathy Charmaz’s grounded theory was undertaken to conduct data collection and analysis for in-depth interviews with 12 research participants who were experiencing the care process. Three main categories were summarized as the theoretical understanding of this research results：Bargaining-the experience of decision-making for institutionalization. Four are included: Seeking care consensus, faced with public opinions, seeking support and affirming values. Correct way- Decision making of hospice palliative care. Including two subtitles: factors affair the decision and you feel good and then I will be well. Inevitable fate- experience of providing accompany at end-of-life. Three subtitle are included: move to the end, Good end, and walk through the valley of the shadow of death. In conclusion, family members have difference dilemmas in the process of companionship. This study suggest that staff members in long-term care facility should respect the relatives’ care choices for the residents and provide appropriate support to meet both relatives’ and residents’ needs related to hospice care and terminal care. High quality care environment and care guidelines should be built as well for staff members when providing hospice care and terminal care.