Abstract
BackgroundOlder people in long-term care facilities are at a greater risk of receiving care at the end of life that does not adequately meet their needs, yet staff in long-term care are often unprepared to provide palliative care. The objective of the study was to explore palliative care nurse specialists’ experiences regarding the benefits of and barriers to the implementation of a palliative care educational intervention, Supportive Hospice Aged Residential Exchange (SHARE) in 20 long-term care facilities.MethodsReflective logs (465), recorded over the course of the yearlong SHARE intervention by the three palliative care nurse specialists from two local hospices, who were the on-site mentors, were qualitatively analyzed by two researchers utilizing inductive content analysis.ResultsCategories emerging from the logs include the importance of relationships, knowledge exchange, communication, and the challenges of providing palliative care in a long-term care setting.ConclusionEvidence from the logs indicated that sustained relationships between the palliative care nurse specialists and staff (registered nurses, healthcare assistants) as well as reciprocal learning were key factors supporting the implementation of this palliative care educational intervention. Challenges remain however in relation to staffing levels, which further emphasizes the importance of palliative care nurse specialist presence as a point of stability.
Highlights
Older people in long-term care facilities are at a greater risk of receiving care at the end of life that does not adequately meet their needs, yet staff in long-term care are often unprepared to provide palliative care
Three categories reflected the benefits of Supportive Hospice Aged Residential Exchange (SHARE), knowledge exchange, communication), while barriers to SHARE are reflected under the category challenges
The relationship that the palliative care nurse specialists forged with facility registered nurses, health care assistants as well as facility managers appeared to have a huge bearing on the success of the uptake of the learning
Summary
Older people in long-term care facilities are at a greater risk of receiving care at the end of life that does not adequately meet their needs, yet staff in long-term care are often unprepared to provide palliative care. The objective of the study was to explore palliative care nurse specialists’ experiences regarding the benefits of and barriers to the implementation of a palliative care educational intervention, Supportive Hospice Aged Residential Exchange (SHARE) in 20 long-term care facilities. As one of the most disadvantaged and vulnerable groups in industrial societies, older people in long-term care facilities are at a greater risk of receiving care at the end of life that does not adequately meet their needs [4]. Within the context of this study, long-term care staff refers to registered nurses and health care assistants (non-health professional support workers) directly involved in the care of residents
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