LAUSR

AIM To identify the facilitators and barriers experienced by professional related to end of life care in nursing homes. DESIGN Descriptive qualitative research with phenomenological orientation, through content analysis. PLACEMENT Nursing Homes at Primary Care District in Granada (Spain). PARTICIPANTS Fifteen clinical professionals with, at least 6 months of experience in nursing homes, without specific background in palliative care. METHODS Three focus groups were undertaken with professionals of different disciplines and nursing homes. Interviews were recorded and transcribed literally. An open and axial coding was performed to identify relevant categories. RESULTS Professionals identified difficulties in the communication with families related to relatives' feelings of guilt, difficulty in understanding the deterioration of their relative, and addressing too late the issue of death. Regarding decision making, professionals recognized that they do not encourage participation of patients. Advance directives are valued as a necessary tool, but they do not contemplate implementing them systematically. Other difficulties that professionals highlighted are lack of coordination with other professionals, related to misunderstanding of patients' needs, as well as lack of training, and lack of material and human resources. Facilitators include relationships with primary care teams. CONCLUSION It is necessary to improve communication among nursing homes professionals, families, patients and other health workers.