Supporting Senior’s Quality of Life in Long-term Care – Early Integration of a Palliative Approach to Care

• New Brunswick has an aging population, with an increasing number of older adults living in long-term care (LTC). These older adults often have serious long-term health issues, and they will eventually require end-of-life or palliative care services. 
• The goal of palliative care is to improve the quality of life of people with serious illnesses and their families by way of early identification, assessment, and treatment of physical, emotional, and spiritual issues to help relieve and prevent suffering. 
• Despite the benefits of palliative care for LTC residents and their family members, there are challenges to integrating palliative care into LTC services, including cost, lack of accessibility, and the time commitment required from LTC staff for palliative education, training, and mentoring. 
• To help address these challenges, this program introduced a 12-module online palliative care education program for LTC staff, focusing on different end-of-life care topics. The program design originally included in-person peer mentorship, but this was deemed unfeasible due to LTC staffing constraints. 
• The program aimed to improve the experience of LTC staff in applying a palliative approach to care while integrating the palliative approach into LTC homes’ usual care processes. In turn, the program was expected to improve the care experience and outcomes of older adults and their families living with serious illnesses. 
• The education program was deployed at one LTC home in New Brunswick over a 12-month period, with one new module posted each month. All 168 care staff at the facility, including Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Resident Attendants (RAs), had access to the program. 
• 53 LTC staff (41 women and 12 men) were surveyed on their competence in palliative care before the deployment of the education program and 35 LTC staff (30 women and 5 men) were surveyed on their palliative care competence after the deployment of the program. The pre- and post-survey participants were not all unique, as it was not possible to maintain a paired (matched) sample. 7 additional staff members (6 women and 1 man) were interviewed on their perception of palliative care at the LTC facility before and after the deployment of the education program. Data was also collected from 22 family members of LTC residents. 

• Based on the project results, online education is a feasible way to promote a palliative approach to care in LTC facilities. However, further research involving a larger sample size, paired samples, and additional LTC facilities is required to fully assess the impact of the intervention. 
• Some LTC staff prefer opportunities for in-person training instead of, or in addition to, online education. 

• Conduct a needs assessment across LTC facilities to gain a better understanding of current palliative care practices, best practices, and the online and/or in-person tools that are currently in use. 
• Incorporate opportunities for in-person learning into future palliative care education initiatives. 
• When funding new programs, make sure to connect programs that are working on similar topics so that they can share lessons learned. 

To learn more read the complete project findings (PDF 144 KB)