Normalising and planning for death in residential care: findings from a qualitative focus group study of a specialist palliative care intervention.

Johnston, N; Lovell, C; Liu, W-M; Chapman, M; Forbat, L

Normalising and planning for death in residential care: findings from a qualitative focus group study of a specialist palliative care intervention.

Johnston, N Lovell, C Liu, W-M Chapman, M

Forbat, L

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Publisher:: BMJ PUBLISHING GROUP
Publication Type:: Journal Article
Citation:: BMJ Support Palliat Care, 2019, 9, (1), pp. e12
Issue Date:: 2019-03

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Field	Value	Language
dc.contributor.author	Johnston, N
dc.contributor.author	Lovell, C
dc.contributor.author	Liu, W-M
dc.contributor.author	Chapman, M https://orcid.org/0000-0003-1333-3448
dc.contributor.author	Forbat, L
dc.date.accessioned	2022-09-10T00:43:07Z
dc.date.available	2016-07-14
dc.date.available	2022-09-10T00:43:07Z
dc.date.issued	2019-03
dc.identifier.citation	BMJ Support Palliat Care, 2019, 9, (1), pp. e12
dc.identifier.issn	2045-435X
dc.identifier.issn	2045-4368
dc.identifier.uri	http://hdl.handle.net/10453/161614
dc.description.abstract	BACKGROUND: Improving access to palliative care for older adults living in residential care is recognised internationally as a pressing clinical need. The integration of specialist palliative care in residential care for older adults is not yet standard practice. OBJECTIVE: This study aimed to understand the experience and impact of integrating a specialist palliative care model on residents, relatives and staff. METHODS: Focus groups were held with staff (n=40) and relatives (n=17). Thematic analysis was applied to the data. RESULTS: Three major themes were identified. The intervention led to (1) normalising death and dying in these settings, (2) timely access to a palliative care specialist who was able to prescribe anticipatory medications aiding symptom management and unnecessary hospitalisations and (3) better decision-making and planned care for residents, which meant that staff and relatives were better informed about, and prepared for, the resident's likely trajectory. CONCLUSIONS: The intervention normalised death and dying and also underlined the important role that specialists play in providing staff education, timely access to medicines and advance care planning. The findings from our study, and the growing wealth of evidence integrating specialist palliative care in residential care for older adults, indicate a number of priorities for care providers, academics and policymakers. Further work on determining the role of primary and specialist palliative care services in residential care settings is needed to inform service delivery models.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	BMJ PUBLISHING GROUP
dc.relation.ispartof	BMJ Support Palliat Care
dc.relation.isbasedon	10.1136/bmjspcare-2016-001127
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing, 1117 Public Health and Health Services
dc.subject.mesh	Advance Care Planning
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Decision Making
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Female
dc.subject.mesh	Focus Groups
dc.subject.mesh	Hospice and Palliative Care Nursing
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Palliative Care
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Residential Facilities
dc.subject.mesh	Right to Die
dc.subject.mesh	Humans
dc.subject.mesh	Palliative Care
dc.subject.mesh	Focus Groups
dc.subject.mesh	Decision Making
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Right to Die
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Residential Facilities
dc.subject.mesh	Advance Care Planning
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Hospice and Palliative Care Nursing
dc.title	Normalising and planning for death in residential care: findings from a qualitative focus group study of a specialist palliative care intervention.
dc.type	Journal Article
utslib.citation.volume	9
utslib.location.activity	England
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2022-09-10T00:43:06Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	9
utslib.citation.issue	1

Abstract:

BACKGROUND: Improving access to palliative care for older adults living in residential care is recognised internationally as a pressing clinical need. The integration of specialist palliative care in residential care for older adults is not yet standard practice. OBJECTIVE: This study aimed to understand the experience and impact of integrating a specialist palliative care model on residents, relatives and staff. METHODS: Focus groups were held with staff (n=40) and relatives (n=17). Thematic analysis was applied to the data. RESULTS: Three major themes were identified. The intervention led to (1) normalising death and dying in these settings, (2) timely access to a palliative care specialist who was able to prescribe anticipatory medications aiding symptom management and unnecessary hospitalisations and (3) better decision-making and planned care for residents, which meant that staff and relatives were better informed about, and prepared for, the resident's likely trajectory. CONCLUSIONS: The intervention normalised death and dying and also underlined the important role that specialists play in providing staff education, timely access to medicines and advance care planning. The findings from our study, and the growing wealth of evidence integrating specialist palliative care in residential care for older adults, indicate a number of priorities for care providers, academics and policymakers. Further work on determining the role of primary and specialist palliative care services in residential care settings is needed to inform service delivery models.

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http://hdl.handle.net/10453/161614