Although long-term care (LTC) home staff of nurses and personal support workers spend the most time providing direct care, their role in end of life decision-making for residents with dementia has largely been unacknowledged. Staff's perceptions of their role play a significant part in how they support people with dementia and family care partners. The purpose of this study was to examine LTC home staff's perspectives of their role in end of life decision-making for LTC home residents with dementia.

For this interpretive descriptive study, 21 semi-structured interviews were conducted in two urban LTC homes with nine personal support worker (PSWs), eight registered practical nurses (RPNs), and four registered nurses (RNs). Additionally, a focus group was conducted, consisting of each a PSW, RPN, and RN. A voice-centred relational analysis was used to situate LTC home staff's perspectives within broader social contexts. Findings suggest that little has changed in LTC homes in the last 50 years. Rooted in dichotomies between medical and social care paradigms, ideologies of rationality and professionalism created tensions, hierarchical roles, and staff's minimal involvement in decision-making. A relational approach is needed to account for the interdependency of care and the relationships that LTC home staff have with residents, family care partners, and the sociopolitical environment.

尽管护士和个人支持工作者的长期护理 (LTC) 家庭工作人员花费最多的时间提供直接护理，但他们在痴呆症患者临终决策中的作用在很大程度上未被承认。员工对其角色的看法在他们如何支持痴呆症患者和家庭护理伙伴方面发挥着重要作用。本研究的目的是检查 LTC 家庭工作人员对他们在 LTC 家庭痴呆症患者临终决策中的作用的看法。

对于这项解释性描述性研究，在两个城市 LTC 家庭中进行了 21 次半结构化访谈，其中包括 9 名个人支持工作者 (PSW)、8 名注册实习护士 (RPN) 和 4 名注册护士 (RN)。此外，还进行了一个焦点小组，由每个 PSW、RPN 和 RN 组成。使用以声音为中心的关系分析将 LTC 家庭工作人员的观点置于更广泛的社会背景中。调查结果表明，LTC 家庭在过去 50 年中几乎没有变化。植根于医疗和社会护理范式之间的二分法，理性和专业主义的意识形态造成了紧张局势、等级角色和工作人员对决策的最小参与。需要一种关系方法来解释护理的相互依赖以及 LTC 家庭工作人员与居民之间的关系，