Liesbeth Van Humbeeck

Aged parents’ experiences during a critical illness trajectory and after the death of an adult child: A review of the literature

Background: Given the growing life expectancy, the likelihood increases that health-care providers are confronted with older people having an adult child with a life-limiting disease. Aim: This literature review aimed to (1) explore the experiences of aged parents with regard to their position and role as a parent of an adult child with a life-limiting illness, (2) detect gaps in the existing literature and (3) make recommendations for future research. Design: A literature search of English articles, including both quantitative and qualitative designs. Data sources: Four electronic databases and the reference lists of included studies. Results: In total, 19 studies (7 quantitative and 12 qualitative) were included. Few studies describe the experiences of older people whose adult child has cancer or has died of cancer. Existing studies are merely descriptive and give no concrete recommendations for health-care providers in daily practice. The studies suggest that aged parents carry deep burdens from the prospect of losing their adult child. Aged parents want to stay involved but need to reconfigure their parent role. As soon as the cancer diagnosis is disclosed, parents are confronted with a re-awakening of parental nurturing, which clashes with the autonomy of the adult child. Even after the adult child is deceased, older parents retain the image of themselves as parents. Conclusions: There is a need for more in-depth research to understand the lived experience of these parents and what health-care providers can do to assist them.

Grief and loss in older people residing in nursing homes : (un)detected by nurses and care assistants?

AIM The aim of this study was to explore how nurses and care-assistants (nursing staff) working in six Flemish nursing homes experience and describe their involvement in grief care. BACKGROUND Although grief in older people is widely described in literature, less is known about how nursing staff in nursing homes offer and perceive grief care. DESIGN A qualitative research design with elements of constructivist grounded theory was used. METHODS Loosely structured face-to-face interviews were done with fourteen nurses and care-assistants. Data were collected from October 2013-March 2014. Interview transcripts were analysed using the Qualitative Analysis Guide of Leuven (QUAGOL) method with support of NVivo 10. FINDINGS Grief care in nursing homes is characterized by a complex tension between two care dimensions: (1) being involved while keeping an appropriate distance; and (2) being while doing. Nursing staff described key enablers and influencing factors for grief care at the level of both the individual and the organizational context. CONCLUSION Findings suggest an established personal sensitivity for grief care considered from the nursing staff points of view. Nevertheless, a common denominator was the necessity to further develop a supportive and multidisciplinary grief care policy ingrained in the existing care culture. Suggested components of this grief care policy are: (a) centring attention on non-death-related loss and the cumulative nature of loss in residents; (b) building capacity by means of reflective practices; and (c) the importance of self-care strategies for nursing staff. Furthermore, the findings from this study point towards a need for education and training.

Review: Working in small-scale, homelike dementia care: effects on staff burnout symptoms and job characteristics. A quasi-experimental, longitudinal study

In 2010, 36 million people worldwide had dementia and this is projected to increase to 115 million by 2050 (Prince et al., 2013). Sudden changes in health state, family ability, attitudes towards health care services and limits on available home care services, however, may predispose older adults with dementia to a transition into a nursing home (NH) (Robison et al., 2012). In recent years, there have been important developments and changes in the models of care for persons with dementia in the NH setting (Verbeek et al., 2009). Over the past few decades, new care models that are more person-centred and directed toward smallscale and homelike environments have been developed. This shift clearly impacts the daily life of residents, but also the scope and content of the responsibilities, activities and tasks of nursing staff. This may eventually affect quality of care and job satisfaction. It is thus crucial to understand the relationship between nursing staff’s work environment attributes and job characteristics. Verbeek and colleagues aimed to explore the effects of working in these small-scale living facilities on staff burnout symptoms and job characteristics. The study formed part of a much larger research project on the effects of small-scale living on residents’ well-being. In establishing the contextual ground for the authors’ inquiry, they observe that in global terms previous studies have focused on the effects small-scale living facilities may have on residents and, to a lesser extent, on nursing staff. Existing studies zoom in on this relationship by means of cross-sectional designs. This current study uses a quasi-experimental, longitudinal

The suffering in silence of older parents whose child died of cancer: A qualitative study

ABSTRACT As life expectancy grows, the death of an adult child becomes a highly prevalent problem for older adults. The present study is based on nine interviews and explores the experience of parents (≥70 years) outliving an adult child. The bereaved parents described some silencing processes constraining their expression of grief. When an adult dies, the social support system nearly automatically directs its care towards the bereaved nuclear family. Parental grief at old age is therefore often not recognized and/or acknowledged. Health care providers should be sensitive to the silent grief of older parents both in geriatric and oncology care settings.