Background Nursing homes for older adults have been disproportionately affected by the Covid‐19 pandemic with increased mortality of residents and staff distress. Objective To quantify the mental health of nursing home staff during the Covid‐19 pandemic in the Republic of Ireland. Design/Methods Cross‐sectional anonymous study of Republic of Ireland nursing home staff ( n = 390) during the third wave of the Covid‐19 pandemic. Online survey collecting demographic information, Covid‐19 exposure history and mental health measures. Results There were significant differences between nurses, healthcare assistants (HCA) and non‐clinical staff history in age, ethnicity, years' experience, history of Covid‐19 infection and contact with Covid‐19 positive acquaintances. Moderate–severe post‐traumatic stress disorder symptoms were found in 45.1% (95% confidence interval [CI] 40.2%–50.1%) of all staff. A World Health Organisation‐5 (WHO‐5) wellbeing index score ≤32, indicating low mood, was reported by 38.7% (95% CI, 33.9%–43.5%) of staff; significantly more nurses reported low mood. Suicidal ideation and suicide planning were reported, respectively, by 13.8% (95% CI, 10.4%–17.3%) and 9.2% (95% CI, 6.4%–12.1%) of participants with no between‐group differences. HCAs reported a significantly higher degree of moral injury than non‐clinical staff. Nurses were more likely to use approach coping styles than non‐clinical staff. Work ability was insufficient in 24.6% (95% CI 20.3%–28.9%) of staff. Conclusion Nursing home staff report high levels of post‐traumatic stress, mood disturbance and moral injury during the Covid‐19 pandemic. Differences in degree of moral injury, wellbeing and coping styles were found between staff groups, which need to be incorporated into planning supports for this neglected workforce.

ObjectivesThe importance of palliative care in those with advanced fibrotic interstitial lung diseases (F-ILD) is recognised, but the palliative care requirements of patients and caregivers affected by F-ILD regardless of disease course are not established. We set out to explore this and identify optimal solutions in meeting the needs of a F-ILD population in Ireland.MethodsImplementing a World-Café qualitative research approach, we captured insights evolving, iteratively in interactive small group discussions in response to six predefined topics on palliative care and planning for the future. Thirty-nine stakeholders participated in the World-Café including 12 patients, 13 caregivers, 9 healthcare professionals, 4 industry representatives and 1 representative of the clergy.ResultsPalliative care emerged as fundamental to the care and treatment of F-ILDs, regardless of disease progression. Unmet palliative care needs were identified as psychological and social support, disease education, inclusion of caregivers and practical/legal advice for disease progression and end-of-life planning. Participants identified diagnosis as a particularly distressing time for patients and families. They called for the introduction of palliative care discussions at this early-stage alongside improvements in integrated care, specifically increasing the involvement of primary care practitioners in referrals to palliative services.ConclusionPatients and caregivers need discussions on palliative care associated with F-ILD to be included at the point of diagnosis. This approach may address persisting inadequacies in service provision previously identified over the course of the last decade in the UK, Ireland and European F-ILD patient charters.

ObjectivesTo examine current practices, attitudes and levels of confidence related to advance care planning (ACP) in patients with chronic obstructive pulmonary disease (COPD) among healthcare professionals working in Ireland. This will inform future clinical guidance development.MethodsA cross-sectional survey of healthcare professionals.ResultsThere were 143 participants (109 general practitioners, 25 nurses, 7 physiotherapists and 2 consultant physicians). The majority (82%, n=117) cared for patients with COPD weekly, but only 23% (n=33) had initiated ACP with a patient with COPD over the previous 6 months. Overall, 59% (n=85) answered ≥6 of 8 general knowledge questions correctly. Participants demonstrated positive attitudes towards ACP (mean score 3.6/5.0), but confidence levels were low (2.2/4.0). Most thought ACP was appropriate for patients with severe or very severe COPD (71%, n=101%, and 91%, n=130, respectively) but were unsure or felt that it was not appropriate for those with mild–moderate COPD. However, almost all participants (97%, n=139) stated that if a patient expressed a desire to have ACP discussions, they would comply. Topics most likely to be discussed related to diagnosis and treatment options. Death and end-of-life issues were rarely discussed. The death of a family member or friend and participation in support groups were identified as new ‘triggers’ for initiating ACP.ConclusionsTargeted education to improve general knowledge and confidence levels among healthcare professionals, together with initiatives to increase public awareness of ACP so that patients themselves might be more inclined to start the discussion, may help increase the uptake of ACP for this patient group.

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. The majority of the sample were referred to specialist palliative care teams in their last week(s) of life . Access to formal supports and care packages varied throughout the country.Future plans A report will be made available online with the findings of this audit. This includes recommendations for people with dementia, for family members, for staff and for service planners. Information will also be shared with all of the specialist palliative care teams. Background A range of losses occur throughout a person's journey with dementia. Losses occur for the person and for their families as the disease progresses. Grief as a result of these losses is under-recognised and under-reported by people with dementia and their families. Aim To develop a guidance document and factsheet to support healthcare staff to recognise, acknowledge and respond to loss and grief in dementia. P-138Methods An Expert Advisory Group (EAG) was convened. The group followed the NCEC approach to developing clinical guidance which included literature reviews, consensus building and consultation with key stakeholders.Results The guidance document and factsheets are available to support healthcare staff in working with loss and grief in dementia. The document has four key considerations for staff to use as good practice when working with loss and grief in dementia. These are followed by four guidance areas which are responding to loss and grief, supporting the person with dementia experiencing loss and grief, supporting families with loss and grief and supporting yourself as a healthcare staff member. Resources will be listed for each of these areas. Conclusion Recognising loss and grief as part of the experience of having dementia is a core part of good dementia care. Provision of supports to people and their families at transition points is essential. Future plans This guidance document is one in a suite of seven guidance documents developed relating to different aspects of dementia palliative care. A dissemination plan has been developed to ensure findings and guidance are implemented and evaluated.