Life care planning and long-term care for individuals with brain injury in the UK

2015 ◽  
Vol 36 (3) ◽  
pp. 289-300 ◽  
Author(s):  
Jo Clark-Wilson ◽  
Mark Holloway
Keyword(s):  
Brain Injury ◽  
Long Term Care ◽  
Care Planning ◽  
Life Care ◽  
Term Care ◽  
Life Care Planning ◽  
The Uk

Documentation of nursing home residents' preferences regarding end-of-life care in Japan: Does the documentation serve as an advanced directive in care planning?

2015 ◽  
Vol 3 (3) ◽  
pp. 309 ◽  
Author(s):  
Miharu Nakanishi ◽  
Yuki Miyamoto
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Place Of Death ◽  
Care Planning ◽  
Life Care ◽  
Term Care ◽  
Advanced Directive

Rationale, aims and objective: In 2006, the public long-term care insurance system in Japan introduced a documentation of a nursing home resident’s preferences regarding end-of-life care. However, it is unclear whether the documentation of preferences serves as an advanced directive in care planning. The aim was to examine the association between documentation of a nursing home resident’s preferences regarding end-of-life care and (1) preferences on place of death, (2) comfort at end-of-life in facilities and (3) death of residents in hospitals.Methods: A retrospective study design was used to collect data regarding decedents in long-term care facilities across 3 prefectures in Japan in August 2014. A total of 211 decedents from 62 facilities were included in the analysis. The Managing Director provided information on each resident’s and relative’s preferred place of death, comfort during the last 7 days of life in the facility and actual place of death. The Comfort around Dying End-of-Life in Dementia scale (CAD-EOLD) was used to assess comfort.Results: Residents’ preferences regarding place of death was unable to be determined regardless of completion of routine documentation. Relatives of residents in facilities that completed routine documentation were more likely to prefer that death occurred at the facility. The comfort and likelihood of hospital death did not vary according to the completion of routine documentation.Conclusion: Routine documentation may have confirmed the preferences of relatives instead of residents themselves. Communication strategies should be established as part of the documentation of nursing home resident’s preferences to ensure quality of end-of-life care in accordance with the resident’s preferences.

Challenges in implementing an advance care planning programme in long-term care

2016 ◽  
Vol 24 (1) ◽  
pp. 87-99 ◽  
Author(s):  
Ciara McGlade ◽  
Edel Daly ◽  
Joan McCarthy ◽  
Nicola Cornally ◽  
Elizabeth Weathers ◽  
...  
Keyword(s):  
End Of Life ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Long Term Care ◽  
Care Plan ◽  
Care Planning ◽  
Life Care ◽  
Term Care ◽  
Advance Care

Background: A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. Research aim: To identify challenges in implementing the ‘Let Me Decide’ advance care planning programme in long-term-care. Research design: This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families. Participants and research context: long-term-care residents in two nursing homes and one community hospital. Ethical considerations: The local research ethics committee granted ethical approval. Findings: Following implementation, over 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training. Discussion: The challenges encountered were largely concerned with preserving resident’s autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources. Conclusions: Although it may be too late for many long-term-care residents to complete their own advance care directive, the ‘ Let Me Decide’ programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice.

scholarly journals Cost of shifting from healthcare to long-term care in later life across major diseases: analysis of end-of-life care during the last 24 months of life

2018 ◽  
Vol 13 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Tomoko Terada ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Masashi Kizuki ◽  
Naohiko Inase
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Later Life ◽  
Life Care ◽  
Term Care

Organizing across borders

2005 ◽  
Vol 48 (5) ◽  
pp. 643-653 ◽  
Author(s):  
Chris Holden
Keyword(s):  
Case Studies ◽  
Long Term Care ◽  
Care Work ◽  
Term Care ◽  
User Choice ◽  
Care Services ◽  
Organization Of Care ◽  
The Uk

Internationalized providers of care services face competing incentives and pressures relating to profit and quality. Case studies of corporate providers of long-term care in the UK demonstrate that their mode of organization has important implications for both user choice and the organization of care work. French Les fournisseurs internationalisés sont soumis à des pressions et à des incitatifs concurrentiels pour produire des profits et de la qualité. Des études de cas portant sur les fournisseurs institutionnels d'assistance à long terme au Royaume-Uni révèlent que leur mode d'organisation a d'importantes répercussions tant au niveau du choix des bénéficiaires qu'au niveau de l'organisation du travail d'assistance. Spanish Los prestadores transnacionales de servicios se enfrentan con incentivos que compiten entre sí y con la tensión entre calidad y ganancia. Se estudian unoscasos de prestadores de cuidados de larga duración en el Reino Unido. Estos demuestran que el modo de organización tiene consecuencias importantes, tanto para opciones abiertas al usuario como para la organización de los cuidados.

scholarly journals Correction: Technical-efficiency analysis of end-of-life care in long-term care facilities within Europe: A cross-sectional study of deceased residents in 6 EU countries (PACE)

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0208199 ◽  
Author(s):  
Anne B. Wichmann ◽  
Eddy M. M. Adang ◽  
Kris C. P. Vissers ◽  
Katarzyna Szczerbińska ◽  
Marika Kylänen ◽  
...  
Keyword(s):  
End Of Life Care ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Efficiency Analysis ◽  
Life Care ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Care Facilities

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

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