Abstract
AbstractThe average expected lifespan in Canadian long-term care (LTC) homes is now less than two years post-admission, making LTC a palliative care setting. As little is known about the readiness of LTC staff in Canada to embrace a palliative care mandate, the main objective of this study was to assess qualities relevant to palliative care, including personal emotional wellbeing, palliative care self-efficacy and person-centred practices (e.g. knowing the person, comfort care). A convenience sample of 228 professional and non-professional staff (e.g. nurses and nursing assistants) across four Canadian LTC homes participated in a survey. Burnout, secondary traumatic stress and poor job satisfaction were well below accepted thresholds, e.g. burnout: mean = 20.49 (standard deviation (SD) = 5.39) for professionals; mean = 22.09 (SD = 4.98) for non-professionals; cut score = 42. Furthermore, only 0–1 per cent of each group showed a score above cut-off for any of these variables. Reported self-efficacy was moderate, e.g. efficacy in delivery: mean = 18.63 (SD = 6.29) for professionals; mean = 15.33 (SD = 7.52) for non-professionals; maximum = 32. The same was true of self-reported person-centred care, e.g. knowing the person; mean = 22.05 (SD = 6.55) for professionals; mean = 22.91 (SD = 6.16) for non-professionals; maximum = 35. t-Tests showed that non-professional staff reported relatively higher levels of burnout, while professional staff reported greater job satisfaction and self-efficacy (p < 0.05). There was no difference in secondary traumatic stress or person-centred care (p > 0.05). Overall, these results suggest that the emotional wellbeing of the Canadian LTC workforce is unlikely to impede effective palliative care. However, palliative care self-efficacy and person-centred care can be further cultivated in this context.
Highlights
The average expected lifespan in many Canadian long-term care (LTC) homes1 is less than two years post-admission (Frohlich et al, 2002; Palliative Alliance, 2010; Jayaraman and Joseph, 2013)
In a large cohort of LTC residents with advanced dementia who died less than one year post-admission, only 4.1 per cent were recognised as having less than six months to live, yet 71 per cent died within that period (Mitchell et al, 2004)
The main objective of this research is to describe the capacity of employees working within Canada’s LTC sector to embrace a palliative care mandate, with particular attention to some of the personal qualities that are necessary for this work
Summary
The average expected lifespan in many Canadian long-term care (LTC) homes is less than two years post-admission (Frohlich et al, 2002; Palliative Alliance, 2010; Jayaraman and Joseph, 2013). A relatively low number of people with a primary diagnosis of end-stage organ failure or cancer – who fall within the traditional domain of palliative care – live in LTC. In a large cohort of LTC residents with advanced dementia who died less than one year post-admission, only 4.1 per cent were recognised as having less than six months to live, yet 71 per cent died within that period (Mitchell et al, 2004)
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