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Improving specialist palliative care in residential care for older people: a checklist to guide practice
  1. Liz Forbat1,2,
  2. Michael Chapman3,
  3. Clare Lovell1,
  4. Wai-Man Liu4 and
  5. Nikki Johnston1
  1. 1 Calvary Public Hospital, Canberra, Australia
  2. 2 Australian Catholic University, Canberra, Australia
  3. 3 Canberra Hospital, Canberra, Australia
  4. 4 Australian National University, Canberra, Australia
  1. Correspondence to Professor Liz Forbat, Australian Catholic University, Antill Street, Watson 2602, Canberra; elizabeth.forbat{at}acu.edu.au

Abstract

Objectives Palliative care needs rounds are triage meetings that have been introduced in residential care for older adults to help identify and prioritise care for people most at risk for unplanned dying with inadequately controlled symptoms. This study sought to generate an evidence-based checklist in order to support specialist palliative care clinicians integrate care in residential nursing homes for older people.

Methods A grounded theory ethnographic study, involving non-participant observation and qualitative interviews. The study was conducted at four residential facilities for older people in one city. Observations and recordings of 15 meetings were made, and complimented by 13 interviews with staff attending the needs rounds.

Results The palliative care needs round checklist is presented, alongside rich description of how needs rounds are conducted. Extracts from interviews with needs rounds participants illustrate the choice of items within the checklist and their importance in supporting the evolution towards efficient and effective high-quality specialist palliative care input to the care of older people living in residential care.

Conclusions The checklist can be used to support the integration of specialist palliative care into residential care to drive up quality care, provide staff with focused case-based education, maximise planning and reduce symptom burden for people at end of life.

  • palliative care
  • nursing homes
  • checklist
  • ethnography
  • grounded theory
  • triage.

https://doi.org/10.1136/bmjspcare-2017-001332

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    Footnotes

    • Contributors LF designed the study, led analysis and drafting the manuscript. LF, NJ, CL, W-ML and MC made substantial contributions to acquiring the data, analysis or interpretation. LF, NJ, CL, W-ML and MC contributed to drafting the work or revising for intellectual content. LF, NJ, CL, W-ML and MC have given final approval of the published version. LF, NJ, CL, W-ML and MC agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Competing interests None declared.

    • Patient consent Staff study only. Standard consent form was used to provide own consent.

    • Ethics approval Calvary HREC, Australia and Australian Catholic University.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data sharing statement Any requests for data sharing should be put in writing to the corresponding author.