Training and Practice Gaps in Nursing Home Palliative Care: A Cross-Sectional Study

Area of Science:

• Gerontology
• Palliative Care
• Healthcare Management

Background:

• Palliative care needs are high for nursing home residents, yet access and integration are limited.
• Nursing home staff have varied training, impacting palliative care quality and consistency.
• Understanding staff perspectives is crucial for developing sustainable palliative care models in nursing homes.

Purpose of the Study:

• To assess nursing home clinical employees' attitudes toward and knowledge of palliative care.
• To determine the extent of engagement with advance care planning among nursing home staff.
• To identify perceived valuable components of palliative care for nursing home residents.

Main Methods:

• A cross-sectional survey of 398 clinical employees across seven nursing homes.
• Analysis using median and ordinal logistic regression to identify predictors of attitudes and advance care planning engagement.
• Grouping disciplines into six categories for comparative analysis (MD/NP, RN, social work, rehabilitation, CNAs, LPNs).

Main Results:

• Most staff believe palliative care improves quality of life, but only 68% distinguish it from hospice.
• Prior palliative care exposure and positive attitudes correlate with more frequent advance care planning document checks.
• Physical, occupational, and speech therapists showed less favorable attitudes compared to other disciplines.

Conclusions:

• Gaps in palliative care knowledge and clinical engagement exist among nursing home staff, varying by professional discipline.
• Discipline-specific training and tailored program design can enhance palliative care delivery in nursing homes.
• Improved training can lead to more consistent and value-aligned care for seriously ill nursing home residents.