Nursing Inquiry

2001;

8

(4): 273

R e v i e w

© 2001 Blackwell Science Ltd

Blackwell Science LtdOxford, UKNINNursing Inquiry1320-7881© 2001 Blackwell Science LtdSeptember 2001831000ReviewReviewReviewBOOK REVIEWSSeptember 2001831000ReviewsReviewReview

BOOK REVIEW

Living, dying, caring: Life and death in a nursing home

,by Rosalie Hudson and Jennifer Richmond, Ausmed,Melbourne.

This book provides an analysis of the experiences of resi-dents living and dying in one Melbourne nursing home.With residents having an average life expectancy of 12 monthsafter admission to the nursing home, a palliative care phil-osophy provides the framework for resident-centred care.The book presents a comprehensive analysis of many aspectsof the experiences of dying residents.

The book is well written and easy to read. Each chapterexplores issues from the perspectives of relatives, staffand residents themselves. Perhaps most poignant are thevignettes the authors weave into their discussions and reflec-tions. These vignettes and photographs of several residentsassist the reader to experience the stories. Hudson andHawthorn have bravely included vignettes illustrating lessthan optimal care. Each vignette is complemented with reflec-tions on quality improvements. These reflections and thelists of recommendations at the end of each chapter arelikely to be very useful to the reader.

The first chapter introduces the concept of nursinghome residents as teachers and explores their history andexperiences. Each resident is viewed as a unique individual,facing enormous challenges and deserving of a ‘freshapproach’ from nursing home staff. The challengesresidents face would daunt most of us: dislocation fromhome, living in a community with strangers with whom theymay have little in common, significant physical losses andthe death of co-residents. Residents, staff and relatives all

respond to the death of residents in different ways. For someit is a reminder of their own mortality, intensifying theirgrieving; for others it is a relief.

The authors explore the close bonds between staff, resi-dents and relatives. Resident care is viewed as a partnershipwith residents and families, a partnership that is often chal-lenging. Families may take time to come to terms with nurs-ing home placement or the residents’ ill health. Feelings ofanger, shock or guilt may lead families to become highlycritical and to visit frequently in order to scrutinise care.Other relatives may experience such difficulties that they donot visit at all. In each of these situations the gerontic nurseattempts to understand the experiences of relatives in orderto foster a more productive partnership.

Poignant political issues, including the prevalence ofageism in our society, are discussed. The stigma of workingin a nursing home and the lack of resources are two clearexamples of it. Hudson and Hawthorn discuss a number ofcreative and innovative strategies to assist in overcominglimited resources. They also highlight that the greatestresource in nursing homes is the commitment and skill ofnursing home staff. Despite the negative media attentionreceived by nursing homes, it is clear from this book thatthere are nursing homes that provide exceptional care.

Hudson and Richmond have succeeded in creating abook that celebrates residential-aged care. The book cele-brates the lives of nursing home residents and the enormouscontributions of nursing home staff and volunteers. Forthose interested in learning more about aged care and forthose caring for older patients, this book offers an excellentmodel of individual-centred care.

Catherine Barrett

School of Postgraduate Nursing,University of Melbourne

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