Death in long-term care: focus groups and interviews identify strategies to alleviate staff burnout

Context: Interdisciplinary long-term care staff are being challenged with increasing numbers of resident deaths as well as complex resident and family needs. Studies warn that staff responses to the stress generated by residents’ deaths can lead to increased ill health, sick time, burnout, and attrition. Objectives: To alleviate and prevent workplace stress and burnout in staff related to long-term care resident deaths. Methods: Participatory action research design. Qualitative individual interviews and focus groups were carried out within five long-term care homes, Vancouver, British Columbia, Canada. Findings: Two key themes emerged: Challenges Staff Experienced and Supporting Action Strategies. Challenges are reported under five sub-themes: 1) Differing Expectations, 2) Communication, 3) Acknowledgement, 4) Support, and 5) Education. Supporting Action Strategies to minimize the impact of resident death on staff are presented under four sub-themes: 1) the Individual: Practice self-care, awareness, mindfulness; 2) Team: Enhance end-of-life comfort for residents, strengthen support for families, maximize the use of palliative and spiritual care; 3) Organization: Nurture supportive leadership, improve communication, education, resources and 4) Higher learning: Build palliative care/emotional preparation into the curriculum and promote long-term care as a specialist area of healthcare. Limitations: Results may not generalize to other practice contexts; long-term care homes studied are part of a faith-based organization. Implications: Long-term care policy and system changes are needed to support interdisciplinary care staff and provide them with tools, resources, and supports to prevent burnout and cope with the increasing stress of working in long-term care