A Pilot Evaluation of the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) Program

Abstract

Background: Despite increased annual mortality in long-term care (LTC) homes, research has shown that care of dying residents and their families is currently suboptimal in these settings. The purpose of this study was to evaluate resident and family outcomes associated with the Strengthening a Palliative Approach in LTC (SPA-LTC) program, developed to help encourage meaningful end of life discussions and planning. Methods: The study employs a mixed method design in four LTC homes across Southern Ontario. Data were collected from residents and families of the LTC homes through chart reviews, interviews, and focus groups. Results: In total, 39 residents/families agreed to participate in the study. Positive intervention outcomes included a reduction in the proportion of emergency department use at end of life and hospital deaths for those participating in SPA-LTC, improved support for families, and increased family involvement in the care of residents. Residents stated that they appreciated learning about a palliative approach to care and being informed about their current status. Conclusions: The benefits of SPA-LTC for residents and families justify its continued use within LTC. Study results also suggest that certain enhancements of the program could further promote future integration of best practices within a palliative approach to care within the LTC context.

Chart based data as a resource for tracking and improving a person‐centred palliative approach in long‐term care

“…The resident charts which formed the foundation of this analysis were those associated with residents enrolled in a larger study on advance care planning (ACP) in LTC (Kaasalainen et al, 2020).…”

Palliative Approach to Care Education for Multidisciplinary Staff of Long-Term Care Homes: A Pretest Post-Test Study

“…A palliative approach to care can promote a comprehensive person-centered care for residents and their care partners and assist with seamless transition to end-of-life care. A palliative approach to care provides for residents' needs throughout their life trajectory in the LTC homes including advance care planning (ACP) discussions, management of distressing symptoms, psychosocial and spiritual care as well as grief and bereavement support for family, other residents and staff (Kaasalainen et al, 2019). There is higher evidence of an increased risk for decisional incapacity in older adults due to the increasing incidence of cognitive impairment, making it critical to promote early ACP discussions (Siu et al, 2020;Sussman, Pimienta, & Hayward, 2021).…”

Australian residential aged care home staff experiences of implementing an intervention to improve palliative and end‐of‐life care for residents: A qualitative study

“…Palliative care education and training for healthcare professionals and careworkers have been shown to improve knowledge, attitudes, self-efficacy, confidence and communication skills (Iida et al, 2021;Lamppu & Pitkala, 2021;Spacey et al, 2020). In Canada, well-tailored PC education has been successful in reducing emergency department use at the end-of-life, improving support for families and increasing family involvement in the care of residents (Kaasalainen et al, 2020). The Supportive Hospice Aged Residential Exchange intervention indicates that education improves staff support to families through the end-of-life journey in New Zealand (Frey et al, 2020).…”