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APHA Scientific Session and Event Listing

Charles E. Gessert, MD, MPH, Division of Education and Research, SMDC Health System, 400 E 3rd Street, Duluth, MN 55805-1983, 218-786-8176, cgessert@smdc.org and Sarah A. Thompson, RN, PhD, School of Nursing, Kansas University Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160-7502.

Background: Quality of life (QOL) of nursing home (NH) residents is affected both by factors that are endogenous to the individual residents and by environmental factors, such as institutional policies and practices. While some NH assess QOL, few examine resident suffering or the role that institutions may play in causing or ameliorating suffering. Methods: Data was obtained as part of a large, longitudinal study that examined end-of-life experiences in two nursing homes in the Kansas City area. Data was collected using a case study approach, incorporating observations, document review, and interviews with declining residents, family members and staff. Qualitative content analysis was used to analyze data. This analysis focused on the profound psychosocial and existential suffering that was experienced by many of the nursing home residents. Results: The narratives of two residents who exemplified the suffering experiences of many of the residents in the larger study were selected for in-depth analysis and presentation. Through these narratives, specific examples of physical, psychosocial, and existential suffering are revealed. The experiences of these residents illuminate the profound roles that NH may have in causing or exacerbating resident suffering, as well as the steps that may readily be taken to relieve suffering. Discussion: Suffering as an essential aspect of the human condition is explored within the context of nursing homes as systems of care for older adults. Attention to suffering is integral to quality of life, yet few nursing homes have integrated the diagnosis and relief of suffering into their routine work.

Learning Objectives:

• List potential causes of suffering of elderly nursing home residents near the end of life.
• Describe the roles that nursing homes may have in exacerbating and/or relieving the suffering of elderly residents near the end of life.

Keywords: Long-Term Care, End-of-Life Care

Presenting author's disclosure statement:

Not Answered