Background The percentage of patients dying in care homes is steadily increasing, with 70% of permanent residents dying in their care home (Public Health England, 2017). Therefore, it is important to understand what is happening to the local population of care home residents at the end of life and their preferences for care.
Aims To assess the impact of involvement of Specialist Palliative Care, for care home patients, on deaths in usual place of residence, hospital admissions in last 90 days of life as well as length of stay in hospital in the six months prior to death. To assess the impact of advance care planning.
Methods A retrospective review of patients who were resident in care homes was undertaken. These patients were known to the Community Palliative Care Team and died between 16 September and 16 December 2018. The electronic patient records were used to gather the data, alongside requesting information from Business Intelligence at the local hospital Trust to obtain information regarding hospital admissions.
Results 74% of patients achieved their Preferred Place of Death (PPD) in this audit. 2/3 of those not achieving PPD had requested hospice transfer. 89% died in the care home and only 4% died in hospital. However, 41% of patients had three or more admissions to hospital within the last six months of life. 93% had documented evidence of having a DNACPR (Do Not Attempt Cardio-pulmonary Resuscitation) form in place and there was evidence of advance care planning for 85% of patients.
Conclusions Further exploration is required around the reasons these patients are being admitted to hospital. Our action plan includes signposting care homes to available education, sharing learning with generalist colleagues and encouraging After Death Analysis at GSF meetings.
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