Empowering Residents and Families for Care Decisions at End of Life

Abstract

Emphasis on client‐centred care is the philosophy for most health care institutions. Long‐term care nursing homes have adopted this philosophy as well, with added emphasis on quality End‐of‐Life Care. Medical advancements have made End‐of‐Life care more complex and individuals and families are often asked to make crucial care decisions in the midst of crisis for their loved ones that may not be in accordance with the actual wishes of their loved ones. Fairmount Nursing Home in Glenburnie has been a leader in their expertise in client centered care. This setting provided a welcoming environment for two of the Queen’s 4 th year nursing students to complete a practicum in Community Health Promotion. Our goal was to increase quality of care at End‐of‐Life by stimulating conversations around advanced decision‐ making. The focus was on expanding the knowledge of residents and their families and Substitute Decision Makers and thereby prompting thoughts about discussion before acute illness or crisis. A social assessment and literature search revealed that everyone has “a story to tell” about a personal End‐of‐Life experience. Through the development of a toolkit, reminders in the Fairmount monthly newsletter to advise readers of resources, and a presentation of information and resources at“Family Night”, we intended to encourage earlier important and focused conversations between residents, families and staff. We found that the information we presented promoted both discussion and questions regarding End‐of‐ Life. Strategic work must continue in order to assist people of all ages and stages of life to talk about their values and wishes before a health crisis intervenes and the opportunity for thoughtful choice is lost.