Mercedes Bern-Klug

Learn More
PURPOSE To describe families' decision-making processes, both cognitive and affective, regarding end-of-life treatments for nursing home residents with moderately severe to very severe dementia. DESIGN Naturalistic inquiry provided the framework for this descriptive, qualitative study. METHODS Four focus groups were conducted in selected nursing homes,(More)
More than one-half of the 2.4 million deaths that will occur in the United States in 2004 will be immediately preceded by a time in which the likelihood of dying can best be described as "ambiguous." Many people die without ever being considered "dying" or "at the end of life." These people may miss out on the opportunity to close important relationships(More)
Findings from this qualitative study indicate that family members of nursing home residents hold themselves responsible for overseeing the care of their loved one, representing the resident's perspective and history, and keeping the family connections. These role expectations can be assets to nursing homes. Nursing and social work staff are called on to be(More)
PURPOSE Almost half of people age 85 and older who die annually in the United States die as nursing home residents, yet because it is not always clear who is close to death, not all residents who might benefit from end-of-life care receive it. The purpose of this study is to develop a framework for organizing social interactions related to end-of-life care(More)
We examined families' end-of-life decision making and their interactions with health professionals. Twenty-eight family members of institutionalized dementia patients participated in four focus groups. We found that participating family members were not well prepared for their decision-making roles, and that they: 1) experienced substantial burdens and loss(More)
PURPOSE To improve understanding of nursing home physicians' perspectives regarding end-of-life care, and to suggest directions for further research. METHODS An exploratory qualitative design based on interviews of 12 nursing home physicians, 10 of whom were medical directors. Medical students served as interviewers. SAMPLE A purposeful sampling(More)
Glaser and Strauss reported decades ago that in order for a person to be treated as dying, he/she must be defined as dying. Defining nursing home residents as "dying" can be complicated because most residents are in advanced old age with multiple chronic conditions. Using a social construction theoretical framework, this study looks at the step before the(More)
Guided by Pearlin's stress process model, this study tested the association between parents' care needs, caregivers' structural context, and caregivers' perception of economic stress in providing care for their parents. Multinomial probit regression was conducted with the cross-sectional data from 895 pairs of Chinese oldest-old parents and their(More)
BACKGROUND Social work practitioners have the potential to make meaningful contributions to improving palliative and end-of-life care because of their work in varied and divergent practice settings across the lifespan, their role in addressing mental health needs, grief and psychosocial aspects of well-being, and their commitment to promoting culturally(More)
OBJECTIVES Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers. DESIGN Secondary data analyses of qualitative ethnographic data. SETTING Two nursing homes in a large Midwestern city; 8 months(More)