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Table 2 Critical behaviors of nurses and healthcare aides in caring for nursing home residents dying with dementia

From: Critical nursing and health care aide behaviors in care of the nursing home resident dying with dementia

Behaviors

Characteristics

Operational definitions

Positive

Negative

Recognizing and responding to changes is resident’s pattern of behavior

a) Use of knowledge and skills in dementia and palliative care;

b) Integration of knowing resident’s normal way of being with changes being witnessed;

c) Altering plan of care based on assessment

Behaviors that recognize and act on changes in resident’s normal patterns of behavior

Behaviors that recognize dementia is a terminal illness

Behaviors that fail to acknowledge the significance of the changes in resident’s pattern of behavior

Behaviors that continue with same approach to care

Attending to the person

a) Acknowledge individuality;

b) Therapeutic use of self;

c) Provision of physical and psychological comfort

Behaviors that honor the individuality of the resident

Behaviors that convey an emotional connection toward the resident

Behaviors that seek to achieve and maintain physical and psychological comfort

Behaviors that lack of honoring of the individuality of the resident.

Avoidance of dying residents

Poor symptom management because of a poor knowledge base

Working with family

a) Normalizing dementia and dying;

b) Decreasing potential for future regret;

c) Keeping family comfortable while sitting vigil

Behaviors that reduce potential for future regret

Behaviors that respond to family’s need for information

Behaviors that maintain family involvement and respect expertise of the family

Behaviors that assist with family member’s comfort

Behaviors that exclude family as part of unit of care

Behaviors that are reactive rather than proactive

Passing judgement on family decisions and family behaviors toward the resident

Engaging with others

a) Getting help;

b) Teamwork

Behaviors that actively engage those best able to meet the needs of the resident

Behaviors that exclude others from the care of the resident

Behaviors that maintain hierarchy

Responding after the death has occurred

a) Spending time with resident and family;

b) Remembering and celebrating resident through storytelling

c) Rituals (I think this needs a bit more specificity. Rituals that are family/culturally sensitive and specific

d) What about supporting other staff here?

Behaviors that demonstrate respect toward the resident and family

Behaviors that honor and remember the resident

Behaviors that provide emotional support for self, colleagues, and family members

Avoidance behaviors

Having a positive attitude towards care of the dying

a) Advocate;

b) Mentor;

c) Bearing witness

Behaviors that demonstrate the health care provider has defined personal role in care for dying

Behaviors that show a lack of confidence in care for dying