End-of-life care for nursing home residents: considering the challenges for paramedics

There is a growth of interest in paramedic involvement in end-of-life care issues in general, but one sub-group of the population which clearly requires further investigation relates to people residing in nursing homes. It is known that frequently people in nursing homes, who are nearing the end of their lives, are inappropriately transferred to hospital with potentially negative consequences.

Little is known about paramedics' clinical decision-making in end-of-life care situations involving these patients, so this study makes a valuable contribution by exploring what factors influence paramedics' clinical decisions when asked to transport nursing home residents nearing the end of their lives.

Utilising a phenomenological approach, a total of six paramedics participated in semi-structured interviews. Participants included three female and three male paramedics aged between 24 and 42 years, and their length of service varied between 2–8 years.

The interviews were structured round six core questions (usefully included in the online supplementary appendices) plus photo elicitation using two images depicting both the context and the type of patient providing the focus for this study. The interviews were audio-recorded and subsequently transcribed verbatim prior to analysis.