Context People with dementia may receive sub-optimal end-of-life care (EoLC) in comparison with those who are cognitively intact (Lillyman and Bruce, 2016). Care home staff report feeling poorly-equipped to manage EoLC in dementia (Kupeli et al., 2016). Anecdotal evidence from the delivery of the ABC End of Life Care education programme for care homes by the Hospice of St Francis found challenges for staff included assessment, recognition of dying and symptom control.
The Dementia Nurse in Care Homes project aims to support care home staff in improving the quality of life of people with dementia and their families. A dementia nurse from the Hospice of St Francis will work in three specialist dementia units, a residential care home, a nursing home and a mental health care unit.
Provide clinical support to care home staff to recognise when the person is dying.
Promote compassionate, holistic care in the individual’s familiar environment, preventing inappropriate hospital admission and support those important to them through the bereavement process.
Initiate and support advance care planning, designing and embedding the documentation, culture and education required to sustain this process.
Provide EoLC education through the ABC programme, training the staff to use a supportive care register.
Evaluation and sustainability The ABC end of life care education programme uses a Palliative and EoLC Checklist for care homes for each patient, to record all aspects of support in place, and measure improvements in care. This will be the outcome tool for the Dementia Nurse project. The project is co-funded by Hospice UK and St James Place; the Hospice of St Francis is committed to continuing the post at the project end.
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