Table 2 Themes and subthemes

Symptomatic worsening

Patient feels physical or mental distress.

Patient is repeatedly hospitalized and discharged.

Near-death period approaches.

Lack of patients’ and family caregivers’ EOL awareness

Nurses discuss patient’s wishes and views on life and death in daily conversation.

The prognosis, as perceived by the healthcare provider, differs from the perception of patients/family caregivers.

Declining ADL

Basic ADL decline becomes significant.

Readjustment of long-term care services and the care environment.