
Contents
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Introduction to palliative care in the nursing home Introduction to palliative care in the nursing home
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Demography and epidemiology of dying in a nursing home Demography and epidemiology of dying in a nursing home
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Challenges Challenges
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Complex operating environment ripe for reform Complex operating environment ripe for reform
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Reducing avoidable hospitalizations Reducing avoidable hospitalizations
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Access to hospice and specialist palliative care input Access to hospice and specialist palliative care input
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Opportunities Opportunities
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Promoting a palliative approach in nursing homes Promoting a palliative approach in nursing homes
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Person-centred care Person-centred care
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Creating a palliative care team for each resident based on need Creating a palliative care team for each resident based on need
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Optimizing symptom control Optimizing symptom control
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Advance care planning Advance care planning
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Timely recognition of dying Timely recognition of dying
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A proposed framework for implementing a palliative approach A proposed framework for implementing a palliative approach
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Positive public policy Positive public policy
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Community Community
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Volunteers Volunteers
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Building workforce capacity Building workforce capacity
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Health-care organization Health-care organization
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Reorganizing the health-care workforce Reorganizing the health-care workforce
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Decision supports Decision supports
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Research strategy Research strategy
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Conclusion Conclusion
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References References
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3.4 Palliative care in the nursing home
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Published:March 2015
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Abstract
Internationally, ageing, technological advances, evolving patterns of disease and disability, and changes in family structures have resulted in nursing homes becoming the final residence for many frailer older people. Much of the on-site assistance with activities of daily living in nursing homes is predominately provided by an unregulated or minimally trained carer workforce with registered nurse supervision, while professional nursing and medical care is provided either by on-site or visiting doctors, nurses, and allied health professionals from external services. This chapter details the palliative care needs of older people living in nursing homes and the challenges and opportunities to deliver better end-of-life care to this population, and proposes utilizing the Chronic Care Model as a framework for delivering the elements of a palliative approach to improve care outcomes for residents and their families.
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