Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention

Frey, Rosemary; Barham, Sophia; Balmer, Deborah; Robinson, Jackie; Boyd, Michal; Gott, Merryn

doi:10.21203/rs.3.rs-28446/v2

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…This suggests that NHs must create an open environment in which staff, residents and FCs feel safe and comfortable sharing their feeling and thoughts. Indeed, FCs have reported that they experienced higher‐quality communication and felt more involved in care planning when a team‐based approach to end‐of‐life communication was employed (Frey et al, 2020). NH staff experienced end‐of‐life communication as a socio‐cultural space, in which both staff and FCs felt some resistance to frank communication about death.…”

Section: Discussionmentioning

confidence: 99%

Lived experiences of end‐of‐life communication among nursing home staff: An interpretive phenomenological study

Gonella

Conti²,

Albanesi³

et al. 2022

Journal of Advanced Nursing

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Aims:To explore and understand lived experiences of end-of-life communication among nursing home staff.Design: Interpretive phenomenological study. Methods:In-person, semi-structured, in-depth interviews were conducted from May to August 2021 with 21 nursing home staff members involved in end-of-life communication (four managers, four chief nurses, three chief medical officers, three nurses, three psychologists, two occupational therapists, one chief nurse aide and one nurse aide). Data were analysed by van Manen's hermeneutic approach, which uses the lifeworld existentials of spatiality, corporeality, temporality and relationality to guide reflection on the human experience. Data were reported according to the Consolidated Criteria for Reporting Qualitative Research.Results: Thirteen categories were identified and framed within the four existentials.Regarding spatiality, end-of-life communication took place in a physical, mental, socio-cultural and professional competence space. With regard to corporeality, interviewees reported difficulties in managing their own feelings and those of family caregivers. For temporality, interviewees reported delays in end-of-life communication due to staffing issues and an increase in urgent and temporary relief admissions to nursing homes. To compensate, they tried to assure that all interactions that did take place were of high quality. Finally, with regard to relationality, interviewees lived end-of-life communication through their relationships with family caregivers and colleagues. The supportive role of colleagues was expressed as teamwork, which helped promote reflexivity about how to tailor communication, manage challenging emotions and situations, set aside time for communication, and prepare family caregivers for death. Conclusion:End-of-life communication was an all-encompassing experience for nursing home staff. The supportive role of colleagues was stressed across all existentials, suggesting that teamwork is essential in delivering effective communication at the end-of-life.

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Section: Discussionmentioning

confidence: 99%

Lived experiences of end‐of‐life communication among nursing home staff: An interpretive phenomenological study

Gonella

Conti²,

Albanesi³

et al. 2022

Journal of Advanced Nursing

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“…75 When a team-based approach is employed, family caregivers report higher quality communication and feel more involved in care planning that allows for a better-perceived death for their relative. 76 Therefore, it is the role of all healthcare professionals to create an environment of openness so that patients and their family caregivers feel comfortable to voice their concerns regarding end-of-life issues and can be involved in planning end-of-life care.…”

Section: Recommendationmentioning

confidence: 99%

Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review

Gonella¹,

Mitchell

Bavelaar

et al. 2021

Palliat Med

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Background: Most people with dementia transition into nursing homes as their disease progresses. Their family caregivers often continue to be involved in their relative’s care and experience high level of strain at the end of life. Aim: To gather and synthesize information on interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes and provide a set of recommendations for practice. Design: Mixed-Methods Systematic Review (PROSPERO no. CRD42020217854) with convergent integrated approach. Data sources: Five electronic databases were searched from inception in November 2020. Published qualitative, quantitative, and mixed-method studies of interventions to support family caregivers of people with advanced dementia at the end of life in nursing home were included. No language or temporal limits were applied. Results: In all, 11 studies met the inclusion criteria. Data synthesis resulted in three integrated findings: (i) healthcare professionals should engage family caregivers in ongoing dialog and provide adequate time and space for sensitive discussions; (ii) end-of-life discussions should be face-to-face and supported by written information whose timing of supply may vary according to family caregivers’ preferences and the organizational policies and cultural context; and (iii) family caregivers should be provided structured psychoeducational programs tailored to their specific needs and/or regular family meetings about dementia care at the end of life. Conclusion: The findings provide useful information on which interventions may benefit family caregivers of people with advanced dementia at the end of life and where, when, and how they should be provided.

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“…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). Ahlström et al (2018) describe a four‐stage model of an educational intervention (development, feasibility and piloting, evaluation and implementation) used in Sweden for understanding effectiveness of implementing knowledge‐based PC in nursing homes.…”

Section: Introductionmentioning

confidence: 99%

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

Nagarajan

Poulos

Clayton

et al. 2022

Health Social Care Comm

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Access to high-quality and safe evidence-based palliative care (PC) is important to ensure good end-of-life care for older people in residential aged care homes (RACHs). However, many barriers to providing PC in RACHs are frequently cited. The Quality End-of-Life Care (QEoLC) Project was a multicomponent intervention that included training, evidencebased tools and tele-mentoring, aiming to equip healthcare professionals and careworkers in RACHs with knowledge, skills and confidence in providing PC to residents. This study aims to understand: (1) the experiences of healthcare professionals, careworkers, care managers, planners/implementers who participated in the implementation of the QEoLC Project; and (2) the barriers and facilitators to the implementation. Staff from two RACHs in New South Wales, Australia were recruited between September to November 2021.Semi-structured interviews and thematic data analysis were used. Fifteen participants (seven health professionals [includes one nurse, two clinical educators, three workplace trainers, one clinical manager/nurse], three careworkers and five managers) were interviewed. Most RACH participants agreed that the QEoLC Project increased their awareness of PC and provided them with the skills/confidence to openly discuss death and dying. Participants perceived that the components of the QEoLC Project had the following benefits for residents: more appropriate use of medications, initiation of timely pain management and discussions with families regarding end-of-life care preferences. Key facilitators for implementation were the role of champions, the role of the steering committee, regular clinical meetings to discuss at-risk residents and mentoring. Implementation barriers included: high staff turnover, COVID-19 pandemic, time constraints, perceived absence of executive sponsorship, lack of practical support and systems-related barriers. The findings underline the need for strong leadership, supportive organisational culture and commitment to the implementation of processes for improving the quality of end-of-lifeThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention

Cited by 3 publications

References 23 publications

Lived experiences of end‐of‐life communication among nursing home staff: An interpretive phenomenological study

Lived experiences of end‐of‐life communication among nursing home staff: An interpretive phenomenological study

Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review

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

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