An Initiative of a Nursing Home Outreach Counseling to Improving Palliative Care in Eastern of Saxony-Anhalt, Germany

Abstract

Geriatrics and Palliative Caremanagement in the individual context of the elderly among care teams and networks for dignified living is one of practical-theoreticaland ethical challenges for residential care facilities.Palliative care was defined by World Health Organization (WHO) as an approach improving the quality of life of individuals and their families who are facing problems associated with life-threatening illness, whether physical, psychological, social, or spiritual [4]. Furthermore, essential attributes of ageing-based palliative care models identified by policy were communication and coordination between providers, skill enhancement, and capacity to respond rapidly to individuals' changing needs and preferences over time [5]. Nursing home deaths and Advance Care Planning (ACP) provided advance directive care have been concerned especially during Covid-19 and beyond to promote an appropriate death with meaningful as possible for both the elderly and the family members [6].ACP has been confirmed as a crucial intervention in improving communication, and care satisfaction as well as reduced staff distress through decision-making proceses [7,8]. Certainly, ACP strengthens the iterative process of discussion, decision-making, and documentation related to end-of-life [9]. Thus, ACP has been confirmed for improving quality of end-of-life care and patient and family satisfaction, and reduces stress, anxiety, and depression in surviving relatives [10]. Besides, Case Management (CM) was the element consistently reported in palliative care models for studies provided evidence for effectiveness on health outcomes [5,11]. CM has been shown the benefits on providing counseling and palliative care [12,13]. Integrating CM into palliative care is a logical, feasible, and effective strategy to improve the care of seriously ill patients [14]. Regarding literature, case managers under CM concept, as patient advocates, are perfectly positioned to facilitate the necessary palliative care or end-of-life care conversation, including advance care planning, and securing the essential legal documents that clearly note the patient and support system wishes and care goals [13].Counseling is one of the most common components providing