Abstract
BackgroundResidents living and dying in long-term care (LTC) homes represent one of society’s most frail and marginalized populations of older adults, particularly those residents with advanced dementia who are often excluded from activities that promote quality of life in their last months of life. The purpose of this study is to evaluate the feasibility, acceptability, and effects of Namaste Care: an innovative program to improve end-of-life care for people with advanced dementia.MethodsThis study used a mixed-method survey design to evaluate the Namaste Care program in two LTC homes in Canada. Pain, quality of life, and medication costs were assessed for 31 residents before and 6 months after they participated in Namaste Care. The program consisted of two 2-h sessions per day for 5 days per week. Namaste Care staff provided high sensory care to residents in a calm, therapeutic environment in a small group setting. Feasibility was assessed in terms of recruitment rate, number of sessions attended, retention rate, and any adverse events. Acceptability was assessed using qualitative interviews with staff and family.ResultsThe feasibility of Namaste Care was acceptable with a participation rate of 89%. However, participants received only 72% of the sessions delivered and only 78% stayed in the program for at least 3 months due to mortality. After attending Namaste Care, participants’ pain and quality of life improved and medication costs decreased. Family members and staff perceived the program to be beneficial, noting positive changes in residents. The majority of participants were very satisfied with the program, providing suggestions for ongoing engagement throughout the implementation process.ConclusionsThese study findings support the implementation of the Namaste Care program in Canadian LTC homes to improve the quality of life for residents. However, further testing is needed on a larger scale.
Highlights
Residents living and dying in long-term care (LTC) homes represent one of society’s most frail and marginalized populations of older adults, those residents with advanced dementia who are often excluded from activities that promote quality of life in their last months of life
As the Canadian population continues to age, more people will die in long-term care (LTC), with estimates as high as 52.3% of residents dying in their LTC home by the year 2020 [1, 2]
This study showed that Namaste Care could be implemented within “real-world” conditions with shortened sessions, the feasibility of implementing Namaste Care in LTC could be greatly enhanced with support from others, for example, family members, students, and volunteers
Summary
Residents living and dying in long-term care (LTC) homes represent one of society’s most frail and marginalized populations of older adults, those residents with advanced dementia who are often excluded from activities that promote quality of life in their last months of life. The purpose of this study is to evaluate the feasibility, acceptability, and effects of Namaste Care: an innovative program to improve end-of-life care for people with advanced dementia. As the Canadian population continues to age, more people will die in long-term care (LTC), with estimates as high as 52.3% of residents dying in their LTC home by the year 2020 [1, 2]. Efforts to promote quality of life for residents with dementia have been neglected, for those with advanced dementia. Given the negative side effects and costs of these medications, there is a need for less harmful, non-pharmacological alternatives for treating pain and pain-related behaviors, such as massage, gentle touch, and music [18, 19]
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