Palliative care case conferences in long‐term care: views of family members

Parker, Deborah; Clifton, Karen; Tuckett, Anthony G.; Walker, Helen; Reymond, E.; Prior, T.; McAnelly, K.; Jenkin, Peter; Israel, Fiona; Greeve, K.; Glaetzer, K.

doi:10.1111/opn.12105

Cited by 13 publications

(14 citation statements)

References 19 publications

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“…Families overwhelmingly recommended pMCC and felt that staff appropriately managed their concerns. 8,9 3) Telemedicine is a viable and successful approach to provide palliative care consultation in rural settings. 10,11 4) Strong leadership at palliative MCCs are a necessity, it is also important to have attendance by all teams interacting with a patient at a palliative MCC as this allows a more streamlined and effective care plan to be developed without unnecessary complexity.…”

Section: Resultsmentioning

confidence: 99%

The Development of Practice Guidelines for a Palliative Care Multidisciplinary Case Conference

Furman

Harild

Anderson

et al. 2018

Journal of Pain and Symptom Management

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Section: Resultsmentioning

confidence: 99%

The Development of Practice Guidelines for a Palliative Care Multidisciplinary Case Conference

Furman

Harild

Anderson

et al. 2018

Journal of Pain and Symptom Management

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“…Weekly on site physician visits, interdisciplinary care conferences, or daily bed-side nursing check-ins are all possible avenues for post distribution support and follow up. [48][49]…”

Section: Discussionmentioning

confidence: 99%

Condition-Specific Pamphlets to Improve End-of-life Communication in Long-term Care: Staff Perceptions on Usability and Use

Sussman

Kaasalainen

Lee

et al. 2019

Journal of the American Medical Directors Association

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Objectives: This paper reports findings on the usability and staff use of five condition-specific pamphlets of high prevalence in LTC: dementia, heart failure, chronic obstructive pulmonary disease, renal failure, and frailty. The pamphlets were created in response to residents', families', and staff's recommendations for activating early reflections and communication about end-oflife care. Design: A mixed-method (qualitative and quantitative) survey design was used. Step one collected survey data on the usability of the pamphlets. Step two collected survey data on pamphlet use. Settings and Participants: Two nurses with specialized palliative care training, two resident /family representatives, ten condition-specific specialists, and 33 LTC palliative leads reviewed the pamphlets for usability prior to distribution. 178 LTC home staff in four participating LTC homes reported on pamphlet use. Measures: Specialists and resident /family representatives were asked to provide open comments and LTC home palliative leads were asked to complete a survey on the accuracy, readability and relevance of the pamphlets. After six months of distribution, all staff in participating LTC homes were asked to complete a survey on pamphlet use, usefulness, and comfort with distribution. Results: The pamphlets were reportedly accurate, relevant, and easy to understand. Following six months of availability, most staff in LTC had read the pamphlets, found the information useful, and planned to share them. However half of the staff questioned their role in pamphlet distribution and most had not distributed them. Regulated staff (i.e. staff affiliated with a regulated profession) expressed more comfort sharing the pamphlets than care aides and support staff. Conclusions/Implications: Condition-specific pamphlets appear to hold promise in providing residents and families with relevant information that may activate early reflections and conversations about end-of-life care. However, structured implementation strategies, training and discussions are required to improve staff comfort with distribution, and explore roles in distribution and follow-up.

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“…In the context of palliative care in an intensive care unit, family participation in conferences regarding EOL care promotes communication between families and the doctor, satisfaction and perceived quality of dying for families, and communication of information to families (11)(12)(13)(14)(15)(16). In the context of long-term palliative care, family participation in a conference regarding EOL care affects communication and understanding between the family and the facility's staff, reducing stress, anxiety and undesirable hospitalization (17). However, no study has investigated how family participation may interfere with EOL care in nursing homes.…”

Section: Discussionmentioning

confidence: 99%

End-of-life care conferences in Japanese nursing homes

Nishiguchi

Sugaya

Inamori

2019

DD&T

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In aging societies, nursing homes that provide 24-hour functional support to frail elderly residents (1), who require assistance due to diminished capacity, play an important role in end-of-life (EOL) care. In Japan, EOL care in nursing homes has gradually increased over the past decade (2-4). However, approximately 30% of facilities continue to transfer residents to hospitals for EOL care (2,4). In the remaining 70% of facilities, approximately 40% of the residents receive EOL care and ultimately die in hospitals rather than in nursing homes (2,4). Thus, residents may be transferred to hospitals against their wishes for EOL care. Multidisciplinary care is a requirement of EOL care in nursing homes. However, providing EOL care overnight is challenging. Nurses in nearly all nursing homes work on-call shifts during the evenings (5). Professional caregivers in nursing homes usually perform EOL care without assistance during the nighttime (6). Thus, the professional caregiver's role may be practically the most important. Professional caregivers who do not have sufficient experience with EOL care have fears about EOL care (7). Thus, multidisciplinary care is essential to prevent unnecessary anxiety in nighttime professional caregivers who are inexperienced with EOL care. EOL care conferences were introduced in the Japanese guidelines for EOL care in nursing homes (8), which state that such conferences promote Summary End-of-life (EOL) care conferences have an important role in promoting EOL care in nursing homes. However, the details of the conferences remain poorly understood. A Japanese prefecture-wide survey was conducted to investigate the factors involved in such conferences that contribute to an increase in the amount of EOL care. One hundred fiftythree nursing homes performed the conferences. The outcome was the amount of EOL care provided in nursing homes after adjusting for the facility beds in 2014. We investigated the factors of staff experience with EOL care, frequency of the conferences, years the conferences were conducted, review conferences after EOL care, and professional participants in the conferences. The multivariate analysis revealed significant associations between EOL care in nursing homes and nurses' experience with EOL care (adjusted β coefficient 2.9, 95% confidence interval (CI) 0.52 ~ 5.22, p = 0.017), more than 5 years of continuous conferences (adjusted β coefficient 3.8, 95% CI 0.46 ~ 7.05, p = 0.026), and family participation (adjusted β coefficient-4.0, 95% CI-7.5 ~-0.48, p = 0.026). In conclusion, the continuation of conferences and enrollment of the nurse with experience in EOL care may promote EOL care in nursing homes, while family enrollment in conferences may decrease EOL care in nursing homes. EOL care conferences in nursing homes should be continuously performed by staff, with an experienced nurse undertaking the task of information sharing before discussing EOL care with the patients' families.

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Palliative care case conferences in long‐term care: views of family members

Abstract: Increased communication between staff and family, in the form of a Palliative Care Case Conference, may reduce stress, anxiety and unwanted hospitalisations during the palliative phase.

Cited by 13 publications

References 19 publications

The Development of Practice Guidelines for a Palliative Care Multidisciplinary Case Conference

The Development of Practice Guidelines for a Palliative Care Multidisciplinary Case Conference

Condition-Specific Pamphlets to Improve End-of-life Communication in Long-term Care: Staff Perceptions on Usability and Use

End-of-life care conferences in Japanese nursing homes

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