Continuous Commitment: Long-Term Care RNs' Experience Communicating With Residents and Their Families About End-of-Life Care Preferences.

RNs lead care planning in long-term-care (LTC), yet there are knowledge gaps regarding their communication with residents and families about end-of-life (EOL) care preferences. A sample of 10 LTC RNs were virtually interviewed to describe their EOL care communication experience. Using an interpretative phenomenological framework, narrative analysis within an interpretive constructivism paradigm yielded four concepts-Being Together, Becoming Clear to Become Comfortable, Advocacy to Honor Residents, and Unique Impact on Nurses-which are all part of RNs' commitment to a continuous, dynamic EOL care communication process. Nurses commit to ongoing whole-person assessment and education, becoming proactive advocates for resident-centered, goal-concordant care. Their knowledge was experientially derived, as their nursing education did not adequately prepare them for EOL care communication or complex, multidimensional relationships with residents and families. Further research is needed to evaluate the nature and interaction and relative contribution of the components of EOL care communication in LTC. [Journal of Gerontological Nursing, 48(11), 29-36.].

End-Of-Life Care Communication in Long-Term Care Among Nurses, Residents, and Families: A Critical Review of Qualitative Research.

RNs in long-term care (LTC) are a critical nexus for end-of-life (EOL) care communication with older adult residents and their families. A critical review of 17 qualitative research studies examined nurses' experience with EOL care in LTC. Findings indicate that time, preparation, advocacy, organizational resources, and a continuous, relational approach support EOL care communication. Regulatory burdens, understaffing, workflow demands, family and organizational dysfunction, anxiety, and depression impede EOL care communication. The current review revealed a gap in the literature describing LTC RNs' unique perspectives and knowledge regarding EOL care communication with residents and families. There is a current, pressing need to understand the facilitators LTC RNs use to overcome obstacles to effective EOL care communication. Future research could inform clinical practice guidelines and EOL care nursing education, enhancing LTC nurses' capacity to develop trust-based relationships and improving the efficacy of current EOL care communication interventions in LTC. [Journal of Gerontological Nursing, 47(7), 43-49.].