scholarly journals Impact of the COVID-19 pandemic on end of life care delivery in care homes: A mixed method systematic review

2021 ◽  
pp. 026921632110298
Author(s):  
Adam Spacey ◽  
Sam Porter ◽  
Michele Board ◽  
Janet Scammell
Keyword(s):  
Systematic Review ◽  
End Of Life ◽  
End Of Life Care ◽  
Service Providers ◽  
Care Delivery ◽  
Care Homes ◽  
Current Evidence ◽  
Future Research ◽  
Life Care ◽  
The Impact

Background: Current evidence suggests that COVID-19 is having a negative impact on the delivery of end of life care in care homes around the world. There is a need to collate current evidence to provide a comprehensive overview to assess extent of the problem. Aim: To describe and evaluate the impact of the COVID-19 pandemic on end of life care delivery in care homes. Design: Systematic review and narrative synthesis of studies reporting qualitative and quantitative data. Data sources: The databases MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and March 2021. Results: Nine studies were included. For care home staff, challenges included significant increases in responsibility and exposure to death, both of which have taken an emotional toll. Results indicate that staff tended not to be offered adequate emotional support or afforded the time to grieve. For those receiving end of life care, results indicate that the end of life care that they tended to receive, especially in the form of advance planning, was disrupted by the pandemic. Conclusion: The effect of the pandemic has been to exacerbate existing problems in the provision of end of life care in care homes for both service providers and users, making that which was previously opaque starkly visible. Future research is needed to explore the effects of the pandemic and its management on those receiving end of life care in care homes and their significant others.

Does post-registration palliative care education for nurses improve practice? A systematic review

2019 ◽  
Vol 25 (11) ◽  
pp. 552-564 ◽  
Author(s):  
Angela Thavaraj ◽  
Karen Gillett
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
End Of Life ◽  
Outcome Measures ◽  
End Of Life Care ◽  
Quantitative Data ◽  
Life Care ◽  
Care Education ◽  
Palliative Care Education ◽  
The Impact

Aims: We aimed to answer the question: what is the evidence that post-registration palliative care education for nurses improves practice? Background: The 2008 End of Life Care Strategy emphasised the need for a workforce equipped to provide high-quality end-of-life care for patients and their families. As registered nurses are the healthcare professionals spending most time with patients and families at the end of life, associated policy documents stress the importance of educating nurses to equip them with the necessary knowledge and skills to provide effective care. Despite education being a consistent recommendation, the ability of education to influence nursing practice is uncertain. Methods: We undertook a systematic review of literature using Joanna Briggs Institute Methodology for Mixed Methods by searching the Medline, Embase and CINAHL databases between January 2006 and December 2018. Findings: Ten studies met the inclusion criteria, seven contained quantitative data. Six demonstrated improvements in outcome measures, but not all results were statistically significant. Most quantitative data related to self-reported measures of confidence. Six studies contained qualitative findings that were categorised into themes: confidence, practice change, skills and proactivity. Conclusion: Little research exists exploring the impact of post-registration palliative care education for nurses. Existing outcome measures do not clearly demonstrate changes to end-of-life practice. Research is suggested to establish links between self-reported confidence and improvements to practice. Evaluation of the impact on practice should be an integral component of end-of-life education initiatives.

scholarly journals EMPOWERING CARE HOME STAFF TO DELIVER QUALITY END OF LIFE CARE: THE IMPACT OF THE SIX STEPS TO SUCCESS PROGRAMME ON END OF LIFE CARE IN CARE HOMES IN NORTH WEST ENGLAND

2014 ◽  
Vol 4 (Suppl 1) ◽  
pp. A32.2-A32
Author(s):  
Mary O'Brien ◽  
Jennifer Kirton ◽  
Katherine Knighting ◽  
Rob Gandy ◽  
Barbara Jack ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Care Home ◽  
Care Homes ◽  
Life Care ◽  
North West ◽  
Care Home Staff ◽  
The Impact

Family Caregivers’ Pain Management in End-of-Life Care: A Systematic Review

2016 ◽  
Vol 34 (5) ◽  
pp. 470-485 ◽  
Author(s):  
Nai-Ching Chi ◽  
George Demiris
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
End Of Life ◽  
Family Caregivers ◽  
End Of Life Care ◽  
Experimental Studies ◽  
Care Team ◽  
Cochrane Library ◽  
Future Research ◽  
Life Care

Context: Pain management was the most identified burden faced by family caregivers in end-of-life caregiving. Objectives: To synthesize current scientific evidence on family caregivers’ experience of pain management in end-of-life care. Methods: A systematic review was conducted using CINAHL, Embase, PubMed, and Cochrane Library electronic databases. Data were extracted from each included paper and organized into tables to synthesize the findings. Results: Fourteen research papers focusing on family caregivers’ experience of pain management and strategies in end-of-life care were included. Nine were observational studies, 3 were case studies, and 2 were experimental studies. These studies mainly focused on exploring family caregivers’ engagement in pain management and communication with the hospice care team about pain control; family caregivers’ knowledge, skills, and self-efficacy in pain management; and family caregivers’ concerns and experience of pain management. Conclusion: This review identified themes similar to previous reviews on family caregivers of patients with cancer or in palliative care: inadequate knowledge and assessment skills in pain management, misunderstanding of pain medications, and poor communication with the care team. Future research should design educational programs and material for family caregivers to improve their pain management knowledge and skills, communication, and engagement in care. The scientific knowledge on this topic is scarce, and level of evidence is low; it is therefore imperative to have more exploratory studies to expand the quality and quantity of evidence and increase our understanding of family caregivers’ needs and barriers to pain management based on larger and more diverse patient and caregiver samples.

scholarly journals Reciprocal Dynamics of Dignity in End-of-Life Care: A Multiperspective Systematic Review of Qualitative and Mixed Methods Research

2019 ◽  
Vol 37 (5) ◽  
pp. 385-398
Author(s):  
Ping Ying Choo ◽  
Geraldine Tan-Ho ◽  
Oindrila Dutta ◽  
Paul Victor Patinadan ◽  
Andy Hau Yan Ho
Keyword(s):  
Systematic Review ◽  
End Of Life ◽  
Health Care Professionals ◽  
End Of Life Care ◽  
Mixed Methods Research ◽  
Family Care ◽  
Well Being ◽  
Future Research ◽  
Life Care ◽  
Wide Range

Background: Preserving terminally ill patients’ dignity and well-being through dignified and holistic care has become the overarching goal in palliative care services. However, dignity is a multifaceted concept with a wide range of interpretations under different cultural contexts. Aim: The aim of this review is to understand the variations in subjective interpretations and constitutions of dignity in palliative or end-of-life care via an integrative worldview. Design: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and used SPIDER tool to screen for appropriate and relevant articles for analysis. Data Sources: Four major databases were searched including CINAHL, ERIC, Medline, and PsycARTICLES between 2009 and 2018. Forty-eight qualitative studies that examined dignity from the perspectives of patients, family caregivers, and health-care professionals were selected for full text data analysis using thematic synthesis. Results: Analysis of the various concepts of dignity revealed 18 themes that were further categorized into 7 conceptual categories: (1) self-determination, (2) existential liberty, (3) relational connectedness, (4) caregiving revitalization, (5) mindful humanity, (6) patient–family care, and (7) sustainable culture. These 7 categories span across individual, familial, and institutional dimensions, forming a new Dynamic Reciprocity of Dignity model. Conclusions: The Dynamic Reciprocity of Dignity model highlights the importance of adopting a systemic lens to address dignity-related needs and concerns at the end of life, while providing insights on how compassionate care and self-compassion can serve as the foundation of dignified care, which in turn serve as a buffer against patients’ existential suffering as well as caregivers’ burnout and fatigue. Recommendations for clinical practice and future research directions are discussed.

scholarly journals End-of-life care in UK care homes: a systematic review of the literature

2018 ◽  
pp. 174498711875783
Author(s):  
Adam Spacey ◽  
Janet Scammell ◽  
Michele Board ◽  
Sam Porter
Keyword(s):  
Systematic Review ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Homes ◽  
Life Care ◽  
Review Of The Literature

The effect of policy on end-of-life care practice within nursing care homes: A systematic review

2012 ◽  
Vol 27 (3) ◽  
pp. 209-220 ◽  
Author(s):  
Julie Kinley ◽  
Katherine Froggatt ◽  
Michael I Bennett
Keyword(s):  
Systematic Review ◽  
End Of Life ◽  
Nursing Care ◽  
End Of Life Care ◽  
Care Homes ◽  
Care Practice ◽  
Life Care

The impact of a new public health approach to end-of-life care: A systematic review

2015 ◽  
Vol 30 (3) ◽  
pp. 200-211 ◽  
Author(s):  
Libby Sallnow ◽  
Heather Richardson ◽  
Scott A Murray ◽  
Allan Kellehear
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
End Of Life ◽  
End Of Life Care ◽  
Public Health Approach ◽  
Life Care ◽  
New Public Health ◽  
New Public ◽  
The Impact

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.

Pediatric End-of-Life Care in Rural America: A Systematic Review

2021 ◽  
pp. 104990912110642
Author(s):  
Whitney Stone ◽  
Jessica Keim-Malpass ◽  
Melanie J. Cozad ◽  
Mary Lou Clark Fornehed ◽  
Lisa C. Lindley
Keyword(s):  
Systematic Review ◽  
Rural Communities ◽  
End Of Life ◽  
Rural Areas ◽  
End Of Life Care ◽  
Pediatric Care ◽  
Future Research ◽  
Rural Children ◽  
Life Care ◽  
Rural America

Background: Families increasingly desire to bring their children home from the acute care setting at end of life. This transition includes home to rural or remote areas. Little is known about the end-of-life care for children who reside in rural areas. Objective: The purpose of this study was to comprehensively review and summarize the evidence regarding end-of-life care for children living in rural areas, identify key findings and gaps in the literature, and make recommendations for future research. Methods: A systematic review was conducted from 2011 to 2021 using MEDLINE and CINAHL databases. Results: Nine studies met inclusion criteria. Key themes from the literature included: barriers, facilitators, and needs. Three articles identified barriers to end-of-life care for children in rural communities, which included access to end-of-life care and clinicians trained to provide pediatric care. Three studies identified and evaluated the facilitators of end-of-life care for rural children. The articles identified technology and additional training as facilitators. Four studies reported on the needs of rural children for end-of-life care with serious illness. Conclusions: We found major barriers and unmet needs in the delivery of rural pediatric end-of-life care. A few facilitators in delivery of this type of care were explored. Overall research in this area was sparse. Future studies should focus on understanding the complexities associated with delivery of pediatric end-of-life care in rural areas.

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