Perceptions and Lived Experiences of Nurses on End-of-Life Care for Terminally Ill Geriatric Patients: A Phenomenological Study in a Nigerian Tertiary Hospital

Abstract Background: Global population ageing has led to an increasing number of older adults living and dying with chronic, life-limiting illnesses. End-of-life (EoL) care is therefore a critical component of healthcare delivery, particularly for geriatric patients. Nurses play a central role in providing EoL care, offering continuous physical, emotional, and spiritual support to patients and their families. However, in low- and middle-income countries such as Nigeria, palliative and end-of-life care services remain poorly developed, and nurses often provide care in the context of limited training, inadequate resources, and strong cultural and religious influences. There is limited qualitative evidence documenting nurses’ perceptions of EoL care and their emotional and psychological experiences in Nigerian tertiary hospitals therefore this study explored nurses’ perceptions and lived experiences while caring for terminally ill geriatric patients at the University of Ilorin Teaching Hospital (UITH), Nigeria. Methods: A qualitative descriptive phenomenological design was adopted. Seventeen registered nurses with at least one year of experience in providing end-of-life care to terminally ill geriatric patients were purposively selected across multiple clinical units. Data were collected through in-depth, semi-structured interviews which was developed for this study and supplemented with field notes. Interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi’s six-step phenomenological approach to identify significant statements, meanings, and themes. Results: Four major themes emerged: (1) perception and understanding of end-of-life care, (2) recognition and Clinical Identification of the Dying Phase, (3) religious and cultural influence on care delivery, and (4) emotional and psychological experiences of nurses. Nurses perceived EoL care as a compassionate, holistic, and ethically grounded responsibility focused on preserving dignity, comfort, and spiritual peace. Religious beliefs were frequently described as sources of strength for nurses, while cultural taboos surrounding death often hindered open communication with patients and families. Participants reported significant emotional and psychological burdens, including sadness, grief, helplessness, emotional exhaustion, and moral distress, particularly when symptom control was limited by resource constraints. Conclusion: Nurses perceptions and experiences underscore the need for structured palliative care education, culturally sensitive care approaches, and psychological support systems to enhance nurses’ wellbeing and improve the quality of end-of-life care for geriatric patients in resource-limited settings. Clinical Trial registration Number: Not Applicable