Running Head: FAMILY PREPAREDNESS

Family Preparedness and End-of-life Support

Before the Death of a Nursing Home Resident
Student: Bunmi Uvieghara
Student No: 820 431 328
Date Submitted: February 25, 2014
NURS 260: Practical Nursing Theory 2
Professor: Mary Mc Grory
Humber College ITAL

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The Canadian health care team dynamically helps support families and nursing home
residents in achieving optimal health and wellness during their end-of-life process. The dying
process, which is believed to be inevitable, has a great impact on how family members cope
during and after the passing away of a loved one. As residents progress through life, they are
faced with various health issues that demand collective care. The end-of-life support given by the
health care team to family members and residents of a nursing home before death is very crucial.
According to the CNO practice guideline on end-of-life care describes, end-of-life care as the
care provided to a client at the end of his or her life (2009, p.3). It is believed that after the
passing of a loved one, most families that have little understanding of the trajectory of dying
suffer emotional and psychological damage. As a result, in general it is required by the health
care team to enlighten families on this process before the death of their loved one occurs. The
purpose of this paper is to explore family preparedness and end-of-life support before the death
of a nursing home resident. It will reflect on nurses self-development as it will improve the
well-being of the family and resident. The paper will also discuss the effectiveness of the
Evidence Based Practice Guideline as it guides nurses towards a successful nursing outcome.
Nurses improve health care in a professional way through knowledge application by providing
optimal care and supporting the end-of-life process of nursing home residents and their family
members.
Family preparedness and end-of-life support before the death of a loved one is a significant
approach in alleviating families from various health implications. Some families beliefs see
death as good fortune as it reliefs residents of a deteriorating illness. However, it is still a tragic
experience losing a loved one. According to research, most unprepared families emphasized that
they lacked clear communication about the imminent death of the resident. Without a doubt,

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educating family caregivers on the trajectory of dying through proper communication skills is
expected to be done by the health care team. This will enable family members and residents to
make informed decisions about their well-being. Nurses are required to develop therapeutic
nurse-client relationships as they will open up communications when discussing the progressive
diminishing health with families. As families recognise indicators that may result in the death of
a resident through clear communication from nurses, families are able to incorporate effective
personal health practices and coping strategies before the death of their loved one occurs. For
these reasons, family preparedness and end-of-life support before the death of residents should
be discussed with family members in an organised manner by the health care team. This will
allow time for family members to accept and adapt to their loss in the long run. Educating
families will help lessen their grief as they establish a proper palliative care that promotes
wellness and quality of dying for their relative. Additionally, families can also have the
opportunity to reflect on their spirituality and cultural beliefs as they may play a significant part
in their personal well-being and dying process of the resident. Moreover, it is the responsibility
of nurses to collaborate with the health care teams to educate and improve families and residents
care as families prepare to go through this process.
Nurses are accountable for their actions when they are providing care and support for
families and residents of nursing homes. Developing self-knowledge through education is very
important in order to address families concerns and needs. Nurses are in a position to plan
approaches and provide other resources that will inform, support, and prepare family members
when handling the challenge of their loved ones declining health. By increasing knowledge
based on the dying process and applying that knowledge effectively, this will help nurses to
improve families awareness and provide competent and compassionate care irrespective of

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families and residents illness in a significant manner (Batchelor, 2010). In essence, this will
improve family members and residents quality of life during the dying phase. Secondly as
nurses are proficient in their skills providing optimal care, they are required to acknowledge their
roles in detecting indicators that may reveal the trajectory of dying. For example, deteriorating
health factors such as weight loss, low body mass index, diminished activities of daily living,
and lower respiratory infection (Davidson, 2011, p.13) are issues related to trajectory of dying.
This will enable nurses to collaborate with the health care teams to inform and make
knowledgeable decisions with both families and residents that will promote care and comfort.
Nurses should be able to demonstrate effective communication skills by educating family
caregivers in order to establish concrete plans and interventions. It is believed that proper family
understanding of this process will decrease measures that might result in future health
complications in the lives of grieving families. Discussing the trajectory of dying early with
families will enable them to have time to integrate their cultural beliefs, values, and practices as
they play a significant role in their personal well-being. Therefore, having proper knowledge of
the end-of-life issues and factors that pose diminished health outcomes is a step to promoting
optimal care. As nurses plan to continue to utilize their knowledge, skills and abilities, the need
for nurses to guide, encourage, and prepare family members and residents before a death would
be a vital achievement by nurses.
Nurses are expected to function in accordance with the nursing scope of practice when
providing care and support for families and residents. The Evidence-Based Practice Guideline
sets out procedures that are vital for nurses to properly support family members and residents
while they are in nursing homes during the end-of-life process. It is important that nurses assess
whether family members and residents are able to make informed decisions regarding their

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health and palliative care. Appropriate communication techniques are required by nurses in order
to collaborate with other inter-professional teams and family caregivers when discussing
treatments and end-of-life care. As well, developing therapeutic nurse-client relationships are
very important as they help to build trust with families members and residents. Therefore, this
will enable nurses to identify the various treatment options that are decided by families and
residents which will respect both their rights. Knowing the kind of end-of-life care families want
for their relatives is pertinent for the health care team in facilitating treatment plans that meets
these needs. For example, resuscitation may be refused by some religions such as Hindus that
ascribes sickness to karma, which means one reaps what one sows as a result of ones actions.
Therefore, it is the responsibility of nurses and the health care team to include choices made by
families and residents in their plan of treatment to meet the ethical nursing practice standards.
This will enable nurses and significant others to collaborate and implement interventions to
accomplish goals and evaluate the efficacy of care in a professional nursing standard.
The dying phase of a nursing home resident is a very difficult and emotional process for
family members, residents, and nurses. Nurses acknowledge their roles in providing optimal care
as they encourage, comfort, and prepare both families and their loved one during the dying phase
of a nursing home resident. As nurses improve in their skills, in knowledge application and
understanding of the EOF care, they ensure that families and residents needs remain the focus
of the professional services that nurses provide during the end-of-life process (CNO, 2002, p.3).
Nurses are able to identify factors associated with trajectory of dying in advance and enlighten
family members and relatives through appropriate communication techniques. This will allow
everyone involved to develop coping strategies early in the process and give the best quality of
dying care to their loved one before death. The health care team and nurses also collaborate with

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family caregivers and residents in implementing treatment options as it improves the quality of
life of patients and families. As a result, families and residents health care rights are respected.
Moreover, nurses act as advocates on behalf of the families and residents in reinforcing previous
treatment choices that were made in order to promote wellness. Consequently, nurses are able to
set realistic goals and expectations with family caregivers and residents about the end-of-life care
as it supports the professional nursing standards of care. The role of nurses in providing support
and preparing family members before the death of a nursing home resident is essential in order to
meets with the Evidence-Based Practice Guideline set out for nurses in promoting optimal health
for families and their relatives.

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Reference

Batchelor, N.H. (2010). Palliative or Hospice care? Understanding the Similarities and
Differences. Journal of the Association of Rehabilitation Nurses, Volume 35, Issue 2, p. 60.

College of Nurses of Ontario. (2009).The Standard of Care: Guiding Decisions About End-ofLife
Care, 3, 1-8. Toronto, ON: CNO.

College of Nurses of Ontario. (2002).The Standard of Care: Professional Standards, Revised

2002, 3, 1-12. Toronto, ON: CNO.

Davidson, K.M. (edited by D.P. Schoenfelder). (2011). Evidence-Based Practice Guideline:

Family preparedness and end-of-life support before the death of a nursing home resident.
Journal of Gerontological Nursing, 37(2), 11-16.

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