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. 2023 Sep 1;22(1):124.
doi: 10.1186/s12904-023-01239-9.

Preferences and end of life care for residents of aged care facilities: a mixed methods study

Moberley Sarah  1   2   3 , Hewitt Jacqui  4 , Attia John  4   5   6 , Cole Janean  7 , Bevington Joelle  4 , Oldmeadow Christopher  6 , Howard Zach  5 , Hughes Rachel  4   5
Affiliations

Preferences and end of life care for residents of aged care facilities: a mixed methods study

Moberley Sarah et al. BMC Palliat Care. .

Abstract

Background: Residential aged care facilities is one of the most common places to deliver of end of life care. A lack of evidence regarding preferred place for end of life care for residents of aged care facilities impacts on delivery of care and prevents assessment of quality of care. This paper reports the preferences, current status of end of life care and enablers and barriers of care being delivered in line with the wishes of residents of participating aged care facilities.

Methods: We collaborated with six equally sized aged care facilities from the Greater Newcastle area, New South Wales, Australia. An audit of the quality of end of life care for residents was conducted by retrospective medical record review (n = 234 deceased patients). A retrospective review of emergency department transfers was conducted to determine the rate of transfer and assign avoidable or not. Qualitative focus group and individual interviews were conducted and analysed for barriers and enablers to end of life care being delivered in accordance with residents' wishes.

Results: Most residents (96.7%) wished to remain in their residential aged care facility if their health deteriorated in an expected way. Residents of facilities whose model of care integrated nurse practitioners had the lowest rates of emergency department transfers and timelier symptom management at end of life. Family decision making influenced location of death (either supporting or preventing care in place of patient preference).

Conclusion(s): To better provide care in accordance with a person's wishes, aged care facilities need to be supported to enable end of life care insitu through integrated care with relevant palliative care providers, education and communication strategies. Family and community health and death literacy interventions should accompany clinical innovation to ensure delivery of care in accordance with residents' preferences.

Keywords: Nursing Home Care; Symptoms and Symptom Management; Terminal Care.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Unadjusted emergency department transfers per 100 bed-years, by year and facility type
See this image and copyright information in PMC

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