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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

BehaviorsCharacteristicsOperational definitions
PositiveNegative
Recognizing and responding to changes is resident’s pattern of behaviora) 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 persona) 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 familya) 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 othersa) Getting help;
b) Teamwork
Behaviors that actively engage those best able to meet the needs of the residentBehaviors that exclude others from the care of the resident
Behaviors that maintain hierarchy
Responding after the death has occurreda) 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 dyinga) Advocate;
b) Mentor;
c) Bearing witness
Behaviors that demonstrate the health care provider has defined personal role in care for dyingBehaviors that show a lack of confidence in care for dying
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