292 Palliative Care for Older People in Residential Care: From the Inside Out

Abstract

Abstract Background To enhance the quality of care of older people living and dying in nursing homes, it has been suggested that palliative care should be integrated into this care. This study aims to explore what palliative care means in the context of older person residential care. Methods Action research, using a co-operative inquiry (CI) approach was used. A total of 18 healthcare assistants (HCAs) and 16 registered nurses (RGNs) in two residential older person care units, participated. A reflection on deaths that occurred on the units over a six-month period N=23 took place. This facilitated reflection on care given to the residents and assisted in developing an understanding of how palliative care is understood and integrated into caring for residents. Results A number of actions took place. A debriefing group, acknowledging the importance of relationships and a sense of loss experienced by staff on the death of a resident, a group reflection on recognising dying and how this might impact on care a resident receives, and a healthcare assistant group which contributed to developing an understanding of the unique role HCA’s have in this context. Categories that evolved to describe palliative care include, communication, decision making, transitions in care, grief, relationships, experience and the importance of knowing a resident. Conclusion This study has illustrated that palliative care in older person care, is often aligned with dying. In general, end of life care and person-centred care were more commonly used terms. It was suggested that palliative care is an inherent part of this care. There is a need to value the expertise and experience of the nurses and healthcare assistants caring for older people living and dying in residential care. There is also a need to improve the interdisciplinary roles between older person care and specialist palliative care.