Older patients' opportunity to die at home: a qualitative study on home care nurses' experiences.

AIM: This study explores home care nurses’ experiences of facilitating home death for older patients. BACKGROUND: In Norway, the number of individuals over 80 years is expected to increase by over 50% by 2030, leading to a heightened demand for health services for older patients with complex care needs. Despite many seniors wishing to die at home, the percentage who do so remains low; only 1.3% of those over 90 years died at home in 2023. A similarly low rate was observed among those aged 65–79, where 5.7% died at home. METHOD: A qualitative design with three focus groups and one individual interview with home care nurses using Braun and Clarke’s thematic analysis framework was conducted. To provide rigor in the study, the COREQ guidelines were followed. RESULTS: Participants reported that planning for home death for older adults was rare; when the patients’ health deteriorated, they were often hospitalized and received aggressive treatment instead of receiving palliative care at home. Variations in services across municipalities affected the availability of care. Nurses frequently expressed that they felt alone, particularly during evenings and weekends, highlighting the crucial role of involving general practitioners in ensuring safe care. CONCLUSION: The findings indicate that home care nurses need increased competence on how to facilitate home death, better organization of health services, increased patient involvement, and enhanced collaboration between healthcare services to facilitate the possibility of more home deaths among the older patients. CLINICAL TRIAL NUMBER: Not applicable.