"Help with rowing the boat": Implementing and evaluating the Strengthening a Palliative Approach in Long-Term Care...

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Long-term care (LTC) facilities face challenges implementing palliative care despite high resident mortality.
• A gap exists in structured palliative care approaches within LTC settings.

Purpose of the Study:

• To implement and evaluate the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) program.
• To assess the feasibility, acceptability, and preliminary effects of SPA-LTC on resident comfort, end-of-life (EOL) emergency department use, and place of death.

Main Methods:

• An explanatory mixed-methods design was employed across four Canadian LTC homes.
• Quantitative data on resident outcomes and qualitative data from staff and families were collected.

Main Results:

• The SPA-LTC program was implemented, with 74.5% of residents having a Palliative Care Conference (PCC).
• Significant reductions were observed in EOL emergency department visits (RRR: 46%) and hospital deaths (RRR: 88%).
• No significant difference in resident comfort was found, but family members valued communication and relationships.

Conclusions:

• The SPA-LTC program is feasible and supports a family-centered palliative care model in LTC.
• Strong communication and leadership are crucial for successful implementation.
• Further research is recommended to validate these findings.