Uncharted Waters: Influencing Practice Through a Life Course Approach: How Caregivers' Life Experience Can Influence the Care They Give to the Elderly at the End of Life
This project originates from my experience as a Palliative Care Nurse Specialist Educator working from a hospice environment. Observations and collaborative partnerships with staff in Aged Care Facilities provided insight into the palliative care needs of the residents at the end-of-life. Care Assistants (caregivers) provide the majority of direct care and spend most time with residents, with little training for providing that care, to residents with increasingly complex needs. A two phase exploratory descriptive project was designed using the life course research paradigm and life story narrative research to consider what life experience caregivers brought to their caregiving role in an Aged Care Facility in New Zealand and what influence education had on their work life. In the first phase a focus group, following education and the implementation of the Liverpool Care Pathway, was conducted and themes identified from an interdisciplinary staff team discussion. In phase two of the project four of the caregivers participated in a life story interview. The thematic analysis of these transcripts provided insight into the four caregivers' life experience. A novel method termed poetic condensation was used in the study to identify the essence of each person's life story. The researcher then reflected on each of the four life stories and identified the turning point in the person's life and a caring moment from the transcript. The discussion in the thesis reveals the impact of the education sessions and implementation of the Liverpool Care Pathway on the caregivers' practice and how this became a turning point in the delivery of care for the elderly residents particularly those who were dying in the Aged Care Facility. The researcher concludes the thesis by recognizing that her role as a palliative care clinical nurse specialist and educator is necessary to transfer specialist end-of-life knowledge and mentor staff as they shape best end-of-life practice.