Uncharted Waters: Influencing Practice Through a Life Course Approach: How Caregivers' Life Experience Can Influence the Care They Give to the Elderly at the End of Life

摘要

This project originates from my experience as a Palliative Care Nurse SpecialistEducator working from a hospice environment. Observations and collaborativepartnerships with staff in Aged Care Facilities provided insight into the palliativecare needs of the residents at the end-of-life. Care Assistants (caregivers)provide the majority of direct care and spend most time with residents, with littletraining for providing that care, to residents with increasingly complex needs.A two phase exploratory descriptive project was designed using the life courseresearch paradigm and life story narrative research to consider what lifeexperience caregivers brought to their caregiving role in an Aged Care Facilityin New Zealand and what influence education had on their work life.In the first phase a focus group, following education and the implementation ofthe Liverpool Care Pathway, was conducted and themes identified from aninterdisciplinary staff team discussion. In phase two of the project four of thecaregivers participated in a life story interview. The thematic analysis of thesetranscripts provided insight into the four caregivers' life experience. A novelmethod termed poetic condensation was used in the study to identify theessence of each person's life story. The researcher then reflected on each ofthe four life stories and identified the turning point in the person's life and acaring moment from the transcript.The discussion in the thesis reveals the impact of the education sessions andimplementation of the Liverpool Care Pathway on the caregivers' practice andhow this became a turning point in the delivery of care for the elderly residentsparticularly those who were dying in the Aged Care Facility.The researcher concludes the thesis by recognizing that her role as a palliativecare clinical nurse specialist and educator is necessary to transfer specialistend-of-life knowledge and mentor staff as they shape best end-of-life practice.