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end-of-life care, hospice, nursing aides, nursing home



  1. Nochomovitz, Emma MPH
  2. Prince-Paul, Maryjo PhD, APRN, AHPCN, FPCN
  3. Dolansky, Mary PhD, RN
  4. Singer, Mendel E. PhD
  5. DeGolia, Peter MD, CMD
  6. Frank, Scott H. MD, MS


An increasing prevalence in deaths occurring within nursing homes has led to a growing concern surrounding quality issues in end-of-life (EOL) nursing home care. In addition, prior research has failed to emphasize the importance of state tested nursing aides (STNAs) in providing this type of care. The purpose of this study was to examine quality issues in EOL nursing home care within the context of STNAs' comfort in providing this care. A convenience sample of 108 STNAs from four nursing homes in the Cleveland, Ohio area used PDAs to provide answers to an audio questionnaire. Questions included emergent themes from the literature pertaining to EOL care in nursing homes, as well as materials from a national education initiative to improve palliative care. Findings demonstrated lack of comfort in discussing death with nursing home residents and their families and insufficient knowledge surrounding EOL decisions and certain types of EOL care. Overall, the level of comfort providing EOL care was found to be associated with STNAs' perceived importance of EOL care, understanding of hospice, and spiritual well-being.