Comprehending the Medical Treatment Life Wishes of Bedridden Elderly Patients with Verbal Communication Difficulties Findings from the Practices of Nurses Working on Medical Long-term Care Wards (Patient-to-nurse Ratio of 20:1)

• Published in: Journal of Japan Academy of Gerontological Nursing Vol. 26; no. 1; pp. 96 - 104
• Main Authors: Hashimoto, Akiko, Koyama, Takami, Watanabe, Yuko
• Format: Journal Article
• Language: Japanese
• Published: Japan Academy of Gerontological Nursing 2021
• Subjects: comprehending wishes; medical long-term care wards; medical treatment life; older adults
• ISSN: 1346-9665; 2432-0811
• DOI: 10.20696/jagn.26.1_96

  This study aimed to clarify how, in day-to-day hospital life, nurses on medical long-term care wards comprehend the medical treatment life wishes of bedridden elderly patients with verbal communication difficulties. Semi-structured interviews were conducted with nine nurses and the responses underwent qualitative descriptive analysis. The analysis revealed six categories: “Engaging with the patient and watching the patient’s reactions based on summaries and information from the family,” “Deliberately make time to interact and talk to patients and look for small signs while touching their bodies and making close observations,” “Sharing signs unique to the patient with the team, including long-term care and rehabilitation staff,” “Confirming the patient’s wishes for their end-of-life care with the team based on information from the family, who know what the patient wished for when he/she was healthy,” “Putting oneself in the patient’s shoes,” and “Encountering things that cannot be expressed in words but that can be understood from a nurse’s intuition.” Nurses deliberately speak to elderly patients and make an effort to comprehend the patient’s wishes by using their five senses. To do this, nurses require well-honed insight and sensitivity. A workplace environment also needs to be created that allows nurses to talk about patients’ wishes that they have comprehended.