Nursing Guidelines for End-Of-Life Care in Long-Term Care Settings: Sustainable Improvements to Care

Gill, Carole; Hillier, Loretta M.; Crandall, Jacqueline; Johnston, Julie

doi:10.1177/082585971102700308

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…While staff in LTC are well-positioned to identify clinical indicators that may suggest that death is near, such as decreased participation in social activities, reduced food and fluid intake, and increased time in bed (Cable-Williams and Wilson, 2014), their close relationships with residents sometimes preclude them from associating these signs with imminent dying (Cable-Williams and Wilson, 2014). To address this challenge, triggering mechanisms, such as the Palliative Performance Scale, can be used alongside clinical judgment to help attune staff to residents who may be transitioning from restorative care to palliative care and remind staff to engage in discussions with their families about symptoms and expectations associated with dying (Gill et al, 2011;Kaasalainen et al, 2014a). Indeed, when such triggering mechanisms are used to activate EOL communication with families in the form of EOL care conferences, families report having a better understanding of what to expect in the final days of life and feeling involved in EOL care planning (Parker et al, 2016;Durepos et al, 2018).…”

Section: Improving Staffs' Capacities To Discuss Death and Dyingmentioning

confidence: 99%

The relationship between caregivers’ perceptions of end-of-life care in long-term care and a good resident death

et al. 2020

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Objective Quality end-of-life (EOL) care is critical for dying residents and their family/friend caregivers. While best practices to support resident comfort at EOL in long-term care (LTC) homes are emerging, research rarely explores if and how the type of care received at EOL may contribute to caregivers’ perceptions of a good death. To address this gap, this study explored how care practices at EOL contributed to caregivers’ perceptions of a good resident death. Method This study used a retrospective cross-sectional survey design. Seventy-eight participants whose relative or friend died in one of five LTC homes in Canada completed self-administered questionnaires on their perceptions of EOL care and perceptions of a good resident death. Results Overall, caregivers reported positive experiences with EOL care and perceived residents to have died a good death. However, communication regarding what to expect in the final days of life and attention to spiritual issues were often missing components of care. Further, when explored alongside direct resident care, family support, and rooming conditions, staff communication was the only aspect of EOL care significantly associated with caregivers’ perceptions of a good resident death. Significance of results The findings of this study suggest that the critical role staff in LTC play in supporting caregivers’ perceptions of a good resident death. By keeping caregivers informed about expectations at the very end of life, staff can enhance caregivers’ perceptions of a good resident death. Further, by addressing spiritual issues staff may improve caregivers’ perceptions that residents were at peace when they died.

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Section: Improving Staffs' Capacities To Discuss Death and Dyingmentioning

confidence: 99%

The relationship between caregivers’ perceptions of end-of-life care in long-term care and a good resident death

et al. 2020

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“…In a pilot evaluation, LTC staff reported that PPS training sessions helped identify residents who were nearing end of life (Kaasalainen et al 2014). Moreover, Gill et al (2011) found that training about using the PPS in LTC helped staff deliver care promptly and be responsive to residents' immediate needs, so staff were able to prioritize appropriately.…”

Section: Key Components Of Palliative Models In Ltcmentioning

confidence: 99%

Palliative Care Models in Long-Term Care: A Scoping Review

Kaasalainen¹,

Sussman²,

McCleary³

et al. 2019

cjnl

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Objective: The goal of this scoping review was to identify existing palliative models in long-term care (LTC) homes and differentiate between the key components of each in terms of training/capacity-building strategies; resident, family and staff support; and advance care planning (ACP) and goals-of-care discussions. Methods: We conducted a scoping review based on established methods to summarize the international literature on palliative models and programs for LTC. We analyzed the data using tabular summaries and content analysis. Results: We extracted data from 46 articles related to palliative programs, training/ capacity building, family support, ACP and goals of care. Study results highlighted that three key components are needed in a palliative program in LTC: (1) training and capacity building; (2) support for residents, family and staff; and (3) ACP, goals-ofcare discussion and informed consent. Conclusion: This scoping review provided important information about key components to be included in a palliative program in LTC. Future work is needed to develop a model that suits the unique characteristics in the Canadian context.

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Nursing Guidelines for End-Of-Life Care in Long-Term Care Settings: Sustainable Improvements to Care

Cited by 2 publications

References 21 publications

The relationship between caregivers’ perceptions of end-of-life care in long-term care and a good resident death

The relationship between caregivers’ perceptions of end-of-life care in long-term care and a good resident death

Palliative Care Models in Long-Term Care: A Scoping Review

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