First Australian NPs to Develop a Nurse Led Model Which Integrates Palliative Care into Residential Aged Care

Boase, Leanne; Johnston, Nikki

doi:10.1016/j.nurpra.2019.03.013

Cited by 1 publication

(2 citation statements)

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“…As such, reducing avoidable hospital admissions of palliative residents living with dementia should remain a key priority for care homes. However, facilitating this goal often requires the prescription of vital end-of-life medications: a skill remaining beholden to the omnipresent scarcity of general practitioners and palliative care nurse practitioners in aged care ( 18 , 28 , 29 ), especially after-hours. Our findings propose general practitioners may also express hesitancy in prescribing end-of-life medications to residents living with dementia.…”

Section: Discussionmentioning

confidence: 99%

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Staff perspectives on end-of-life care for people living with dementia in residential aged care homes: qualitative study

Juhrmann

Martin²,

Jauré

et al. 2023

Front. Psychiatry

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IntroductionPeople living with dementia in care homes can benefit from palliative approaches to care; however, not all will require specialist palliative care. The generalist aged care workforce is well placed to provide most of this care with adequate training and support systems in place, but little is known about their experiences.ObjectiveTo describe staff perspectives on providing quality end-of-life care for people living with dementia in residential care and their families.MethodsFocus groups and semi-structured interviews were conducted with residential aged care managerial and frontline staff in Australia who were caring for residents living with dementia and end-of life needs. A comprehensive, then snowballing sampling strategy was used in participating care homes. Transcripts were analyzed using reflexive thematic analysis.ResultsFifteen semi-structured interviews and six focus groups were undertaken with 56 participants across 14 sites across two Australian states. Five themes were identified: putting the resident at the center (creating homes not hospitals, knowing the individual, a case management approach); articulating goals to grant wishes (initiating the conversation, broadening death literacy, avoiding hospitalization); a collective call to action (staffing the home, recognizing deterioration and escalating issues, communication channels and engaging GPs, managing medications, psychosocial supports); educating to empower staff (governance and guidance, mentoring juniors, self-care); and facilitating family acceptance (setting expectations, partnering in care, access at all hours).DiscussionAged care staff are committed to providing person-centered palliative and end-of-life care for people living with dementia, recognizing the intrinsic value of each resident, regardless of their declining state. Frontline and managerial staff consider advance care planning, collectively working as part of a multidisciplinary team, access to targeted palliative and end-of-life education and training, and engaging families as key priorities to providing high quality care in care homes.

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Section: Discussionmentioning

confidence: 99%

“…Pastoral care worker participants recalled strategies to facilitate after-hours visits, including getting "lounge chairs in there [resident's room] so families can sleep over" (29) and "making sure they are introduced to the kitchen" (47) to prepare food when staying…”

Section: Access At All Hoursmentioning

confidence: 99%