Master's project identifies, describes, analyses and provides sugestions of solving ethical problems whom social worker is dealing with when working and looking after clients in terminal phase of their life. Master's project is divided into 4 chapters. First chapter is focusing on explanation of terms like dying, aging, nursing home and social worker. Second chapter is about explanation of chosen ethical terms with whom social worker is often dealing with. Third chapter is focusing on each of all areas where problems may occur for social worker during his work, for example moving clients to the hospital, keeping their privacy during stay in a double bed room and optimizing daily schedules of dying patient. Last area of interest is divided into providing tasks like feeding, hygiene and spiritual care. Last chapter is conclusion of those problems with ideas and examples how to solve them. Moving clients in terminal stadium of their life is within competences of a nurse, however, it would be better if nursing homes would have their own doctors, who could examine and analyse each patient individualy. Dying in a double bed room with presence of another patient is uncomfortable and displeasing moment, that could be solved with spare room, where this roommate could stay during last moments of that dying patient. Food is served in accordance with schedule, which could be good to adjust to clients individual needs. Same adjustments would be good in schedule of staff, to ensure 24 hour care. Spiritual care is insufficient, and social worker is responsible for this situation and should fix it along with coopreation of various churches.

Background: Demands to be cared for and die at home are increasing nowadays. The holistic approach of palliative care is to emphasize on alleviating physical and psychological distresses and psychosocial support to patients and their families. The nurses have a significant role in promoting palliative care as guidelines of The National Board of Health and Welfare and The World Health Organization (WHO). Aim: To describe nurses' experiences and perceptions in providing palliative care to adult patients at home. Method: A general literature review of ten scientific articles were retrieved from CINAHL and MEDLINE. The collected data were analysed systematically before processing into the result. Results: Three themes and seven subthemes are identified. Three themes describe: supporting patients and their families, improving work efficiency and organizational factors. Seven subthemes present nurses’ experiences in handling psychosocial and emotional issues, strengthen empowerment, building relationships, interprofessional collaboration, self-development, workload and lack of time, and organization support. Conclusion: The results indicate the importance of increasing knowledge and skills in providing the holistic palliative home care for patients and their families. Organizations' supports and effective interprofessional collaboration are fundamental attributions in promoting adequate palliative care. / Bakgrund: Allt fler väljer att vårdas och dö hemma vilket medför ett ökande palliativt vårdbehov i hemmet. Holistiskt förhållningsätt av palliativ sjukvård fokuserar på att lindra fysiskt, psykiskt symtom och existentiellt stöd till patienter och deras familjer. Sjuksköterskor har en viktig roll i att främja palliativ omvårdnaden utifrån vägledningen av Socialstyrelsens och Världshälsoorganisationen (WHO). Syfte: Att beskriva sjuksköterskors erfarenheter och upplevelser av palliativ vård av vuxna patienter i hemmet. Metod: En allmän litteraturöversiktstudie genomfördes på tio vetenskapliga artiklar som hämtades från databaserna CINAHL och MEDLINE. Insamlad data analyserades systematiskt innan de bearbetades för resultaten. Resultat: Tre huvudteman och sju underteman har identifierats. De tre huvudteman beskriver upplevelser av: stöd till patienter och deras familjer, förbättring av arbetseffektiviteten och organisationsfaktorer. De sju underteman beskriver hur sjuksköterskor hanterar psykosociala och emotionella frågor, förstärkande av empowerment, hur man bygger upp en vårdrelation, interprofessionellt samarbete, självutveckling, arbetsbelastning och tidsbrist samt organisationsstöd. Slutsats: Resultaten pekar på angelägenheten i att förbättra vårdpersonalens kunskap och färdigheter i att sörja för holistiskt palliativ hemsjukvård av patienter och deras familjer. Organisationsstöd och goda interprofessionella samarbeten är en förutsättning för att förbättra kvaliteten i den palliativa sjukvården.

After 1989, we have seen a great development of hospice and palliative care in the Czech Republic. At that period, the first hospice institutions came into being which later broadened their concepts on providing also the at-home care. The main aim of this thesis is to characterize the available concepts of the care of the dying patients in their home environment in the Czech Republic. The initial theoretical section introduces the definitions of the basic concepts of palliative and hospice care; the characteristics of the key institutions providing the at-home care; and deals with the hospice and palliative care legislative. The practical part, based on the use of the qaulitative research design and semi-structured interviews, helps to show the experience of various providers of palliative services. The analytic part depicts two concepts of the care of the dying people, which were identified on the base of the linterviews and which are currently available to patients. Keywords: hospic care, palliative care, mobile hospic, specialized mobile palliative care general practitioner, home care, social services, care of the dying patients, dying, death