scholarly journals P-157  ‘Hospice in your care home’ – a dedicated service aiming to promote high quality palliative and end of life care in the nursing home setting

2016 ◽  
Author(s):  
Debbie Dempsey ◽  
Monica McCahery
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Home ◽  
Life Care ◽  
High Quality ◽  
Home Setting ◽  
Nursing Home Setting ◽  
Dedicated Service

The nursing management required to provide effective end-of-life care in a care home setting: a case study

2021 ◽  
Vol 23 (2) ◽  
pp. 1-7
Author(s):  
Simona Hickey ◽  
Mary Williams
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
Symptom Management ◽  
End Of Life Care ◽  
Ethical Issues ◽  
Care Home ◽  
Life Care ◽  
Home Setting ◽  
Nursing Home Setting

Background: This case study is a practical experience example from a nursing home setting. It will describe how a holistic approach to care, provided to a resident living with dementia at end of life, ensured a peaceful death. Aims: The importance of advance care planning and effective pain and symptom management in end-of-life care will be explored. The psychosocial issues experienced by the resident and their family and any ethical issues associated with the delivery of care will be addressed. The factors and challenges that need to be overcome in order to ensure effective pain and symptom management for the dying patient, particularly in a nursing home setting, are discussed. Finally, this article will make recommendations for future practice. Methods: This is a case study based on an author's experience while working in a nursing home setting. Findings: Challenges associated with end-of-life care have been identified and recommendations have been made.

scholarly journals COMPETENCY BASED TRAINING IN THE NURSING HOME SETTING: PROMOTING QUALITY END-OF-LIFE CARE

2014 ◽  
Vol 4 (Suppl 1) ◽  
pp. A15.1-A15
Author(s):  
Dorry McLaughlin ◽  
Felicity Hasson ◽  
Sue Foster ◽  
Noleen McCorry ◽  
George Kernohan ◽  
...  
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Home Setting ◽  
Nursing Home Setting ◽  
Competency Based

End of Life Care in the Nursing Home Setting

2010 ◽  
Vol 11 (3) ◽  
pp. B10
Author(s):  
Petra Flock ◽  
Petra Flock ◽  
Jill M. Terrien
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Home Setting ◽  
Nursing Home Setting

scholarly journals Key Components for the Delivery of Palliative and End-of-Life Care in Care Homes in Hong Kong: A Modified Delphi Study

2022 ◽  
Vol 19 (2) ◽  
pp. 667
Author(s):  
Helen Yue-Lai Chan ◽  
Cecilia Nim-Chee Chan ◽  
Chui-Wah Man ◽  
Alice Dik-Wah Chiu ◽  
Faith Chun-Fong Liu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Hong Kong ◽  
End Of Life ◽  
Delphi Study ◽  
End Of Life Care ◽  
Care Home ◽  
Local Context ◽  
Life Care ◽  
Home Setting ◽  
Modified Delphi

Integrating the palliative care approach into care home service to address the complex care needs of older adults with frailty or advanced diseases has been increasingly recognized. However, such a service is underdeveloped in Hong Kong owing to socio-cultural and legal concerns. We adopted a modified Delphi study design to identify the key components for the delivery of palliative and end-of-life care in care home settings for the local context. It was an iterative staged method to assimilate views of experts in aged care, palliative care, and care home management. A multidisciplinary expert panel of 18 members consented to participate in the study. They rated their level of agreement with 61 candidate statements identified through a scoping review in two rounds of anonymous surveys. The steering group revised the statements in light of the survey findings. Eventually, the finalized list included 28 key statements concerning structure and process of care in seven domains, namely policy and infrastructure, education, assessment, symptom management, communication, care for dying patients, and family support. The findings of this study underscored concerns regarding the feasibility of statements devised at different levels of palliative care development. This list would be instrumental for regions where the development of palliative and end-of-life care services in care home setting is at an initial stage.

scholarly journals Critical nursing and health care aide behaviors in care of the nursing home resident dying with dementia

BMC Nursing ◽  
2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Genevieve N. Thompson ◽  
Susan E. McClement
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Structured Interviews ◽  
Care Needs ◽  
Two Phase ◽  
Home Setting ◽  
Expert Nurses

Abstract Background With the aging of the population, dying with dementia will become one of the most common ways in which older adults will end their final years of life, particularly for those living in a nursing home. Though individuals living with dementia have complex care needs and would benefit from a palliative approach to care, they have traditionally not been recipients of such care. An important aspect of determining quality in end-of-life care is the identification of expert practices, processes or behaviors that may help achieve this care. However, for those living with dementia in nursing homes, we have a limited understanding of how to best support expert end of life care. To redress this gap in knowledge, the purpose of this study was to examine and describe expert care of the individual with dementia approaching death from the perspective of nurses and health care aides (HCAs) identified by their peers as having special expertise in caring for this population. Methods A qualitative research design known as Interpretative Description was used to conduct the study. Expert nurses and HCAs were identified through a two-phase nomination process. Individual semi-structured interviews were conducted with consenting participants. Data were analyzed using constant comparative analysis to determine the key critical behaviors. Results Analysis of data collected from expert nurses (n = 8) and HCAs (n = 7) revealed six critical behaviors when caring for residents dying with dementia. All nurses and HCAs unanimously endorsed that the overarching goal of care is similar for all residents who are actively dying; to achieve comfort. The six critical behaviors in caring for residents dying with dementia included: 1) recognizing and responding to changes in a resident’s pattern of behavior; 2) attending to the person; 3) working with the family; 4) engaging with others; 5) responding after the death has occurred; and 6) having a positive attitude toward care of the dying. Conclusions The critical behaviors described by nurses and HCAs in this study provides emerging evidence of best practices in care of those with dementia and their families, particularly near the end of life within the nursing home setting.

A training initiative to improve end of life care in the care home setting

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. A117.1-A117
Author(s):  
Anita Roberts ◽  
Sharon Phillips ◽  
Jan Howard ◽  
Ann Astley
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Care Home ◽  
Life Care ◽  
Home Setting ◽  
Training Initiative

Huntington’s Disease: A Caring Approach to the End of Life

2008 ◽  
Vol 9 (2) ◽  
pp. 75-81 ◽  
Author(s):  
Joseph Klager ◽  
Ayana Duckett ◽  
Susan Sandler ◽  
Carol Moskowitz
Keyword(s):  
Decision Making ◽  
Nursing Home ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Disease Progression ◽  
End Of Life ◽  
Advance Directives ◽  
End Of Life Care ◽  
Life Care ◽  
Home Setting

This article describes the challenges of end-of-life care encountered in a specialized long-term care program for people with Huntington’s disease (HD). The Promoting Excellence in End-of-Life Care Huntington’s Disease Workgroup defines the initiation of palliative care as the point at which independent living is no longer possible. Mobility and lifestyle accommodations for people in the nursing home setting with an early-onset disease are a major feature of this program. The primary end-of-life considerations are advance directives decision-making and anticipating end-stage care needs. Disease progression, denial, family conflict, and clinician blind-spots may impede the development of timely advance directives. The unpredictable and idiosyncratic nature of disease progression impacts decision making for end-of-life care settings and approaches: hospitalization, nursing home stay, and in-house hospice care are the available options. The Workgroup has delineated several priority areas for patient care in HD: autonomy; dignity; meaningful social interaction; communication; comfort; safety and order; spirituality; enjoyment, entertainment, and well-being nutrition; and functional competence. This review also includes a description of the program features in each of these areas.

scholarly journals Getting anticipatory prescribing right in end-of-life care

2019 ◽  
Vol 24 (6) ◽  
pp. 274-277 ◽  
Author(s):  
Ben Bowers ◽  
Alison While
Keyword(s):  
End Of Life ◽  
Symptom Management ◽  
End Of Life Care ◽  
Life Care ◽  
High Quality ◽  
Home Setting ◽  
Safety Issues ◽  
Controlled Drugs ◽  
District Nurses

There is a growing number of people who need access to high-quality endof-life care in the home setting. This requires timely assessments of needs, ensuring good symptom management and recognising the roles undertaken by carers. For some patients, a range of medications may need to be put in place to relieve end-of-life symptoms, using ‘anticipatory prescribing’. District nurses must ensure that they acknowledge the patient's voiced preferences and be mindful of the safety issues that arise with the supply of controlled drugs in the home. This article highlights the challenges faced by district nurses providing or dealing with anticipatory prescribing during end-of-life care.

The known unknowns of assisted hydration at the end of life

2021 ◽  
Vol 26 (6) ◽  
pp. 284-285
Author(s):  
Arjun Kingdon ◽  
Anna Spathis ◽  
Ben Bowers ◽  
Stephen Barclay
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
End Of Life ◽  
End Of Life Care ◽  
Shared Decision ◽  
Life Care ◽  
High Quality ◽  
Home Setting ◽  
Known Unknowns ◽  
The Impact

Much is unknown about assisted hydration at the end of life: why rates of usage vary so highly between institutions, cultures and countries, what beneficial or burdensome effects this treatment has, whether there is a place for subcutaneous hydration in the home setting, and how best to communicate about this difficult topic with dying people and their families. In light of a recently published systematic review concerning the impact of assisted hydration at the end of life, this article explores these questions and related issues, concluding that individualisation and shared decision-making are essential aspects of high-quality end-of-life care.

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