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PP18.003 Normalizing end-of-life (EOL) conversations in nursing home through group work
  1. Jodie Lee,
  2. Ma Cecilia Macayaon Llego,
  3. Diana Quah,
  4. Vivien Mok,
  5. Seok Eng Mah and
  6. Bee Ker Tan
  1. St Luke’s EldeCare Residence @ Ang Mo Kio, Singapore


Background Although Advance care planning (ACP) and Preferred Plan of Care (PPC) are pertinent conversations for nursing home (NH) residents, its uptakes in NH are relatively low. Barriers to ACP and PPC conversations are due to manpower crunch, cultural diversity and language barrier between foreign care staff and residents. EOL decisions are often made too late to allow resident’s participation in decision making. EOL conversations with residents/families at the end of life may happen late or not at all.

This study aims to determine (1) the take-up rate of ACP documentation upon completion of group work and (2) the improvement scores of residents’ Satisfaction with Life Scale (SWLS).

Method A sample size of 5 NH residents with mental capacity were recruited for EOL conversation group work, ‘KOPI Talk’. The group work washeld over 6-week period, facilitated by Medical Social Worker (MSW), Physiotherapist and Chaplains. Group activities such as memory box, narratives and visual audio etc were used. 6 thematic death conversation cards were used to discover residents’ values, motivation and lifegoals.

Pre/post SWLS survey were conducted to measure outcome of residents’ cognitive judgement of their satisfaction with their life.

Results Upon completion of group work program, residents were invited to consider documenting ACP conversation with their families. Out of 5 residents, 2 (40%) have agreed and completed ACP facilitated by MSW Associate.

3 (60%) out 5 residents’ SWLS scores were improved.

Conclusion EOL conversation group work had never been undertaken in NH setting. Residents reported gaining valuable opportunity to engage in EOL conversations. Staff gained better understanding of residents’ EOL care preferences. Several barriers were identified, family’s procrastination and resident’s dependence on family for decision making for their healthcare preferences. There is a need to raise awareness on the importance of ACP not just the residents but also their families.

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