The Role, Education, and Experience of Health Care Assistants in End-of-Life Care in Long-Term Care: A Scoping Review

J Gerontol Nurs. 2020 Jan 1;46(1):21-29. doi: 10.3928/00989134-20191022-01.


The changing age profile of the human population globally means that the requirement for residential long-term care (LTC) for older adults is escalating, with an associated increase in deaths in these facilities. Health care assistants (HCAs), whose main role is provision of direct care to residents, comprise the largest staff cohort in residential care for older adults. The purpose of this scoping review was to explore three key areas related to HCAs: their role and responsibilities, end-of-life (EOL) education, and their views and experiences of caring for residents at EOL. The literature search included five databases and 32 studies were ultimately reviewed. Key issues were as follows: HCAs feel marginalized and undervalued, they need and desire EOL education, and resident deaths impact negatively on them. The changing care needs for older adults with complex comorbidities at EOL in LTC will place an increased onus on HCAs' skills, knowledge, and personal and professional development. [Journal of Gerontological Nursing, 46(1), 21-29.].

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Allied Health Personnel / education*
  • Allied Health Personnel / psychology*
  • Female
  • Homes for the Aged / statistics & numerical data
  • Humans
  • Leisure Activities / psychology*
  • Long-Term Care / methods*
  • Long-Term Care / psychology*
  • Male
  • Middle Aged
  • Nursing Homes / statistics & numerical data
  • Patient Education as Topic*
  • Pennsylvania
  • Terminal Care / methods*
  • Terminal Care / psychology*