Objects: The research interest of this paper is based on the notion that Palliative Care is a core concept for needs-orientation. Vulnerability of frail elderly people in nursing homes and the question how to meet the needs of this special target group within the institutional setting are focussed.
Methods: The methodological background of this study is composed of a theoretical framework based on systems theory. Case studies in different institutions in Vienna (Austria) and Edmonton (Canada) have been conducted. The triangulation of methods leads to a combination of qualitative interviews and the analyses of written documents. The interviews with residents, relatives, nurses, doctors, therapists and management are the main basis for the qualitative interpretation.
Results: In this paper the principle results concerning the delivery of end of life care in nursing homes will be presented. It was observed that the programmes and services that are delivered for end of life care vary considerably between the different institutions. All the nursing homes described three common themes and challenges: 1. the importance of adequate supply of medical assistance, 2. the crucial role of relatives and the ways institutions and professionals communicate with them, and 3. the difficulties to enable needs-oriented decisions during the last days of the frail elderly.
Conclusion: Palliative Care for frail elderly people in nursing homes faces high demands. In addition to improve knowledge and skills in nursing, medicine and other disciplines, it will be argued that communication, organization and management plays an essential role in the end of life care of elderly people.