Palliative care intervention improves quality of death in care home residents

Palliative care specialists can help enhance the quality of death and dying (QODD) among elderly residents of care homes, a recent study has shown.

Researchers performed a stepped wedge randomized controlled trial on 12 participating care homes, corresponding to 1,700 nonrespite residents. The intervention under investigation was Palliative Care Needs Rounds, a monthly hour-long meeting among home staff where patients at risk of dying without a plan were discussed. Needs Rounds meetings were headed by a specialist in palliative care.

Study outcomes included the residents’ QODD and the self-assessed confidence and capability of adopting a palliative approach among staff.

A third (n=567) of the residents died during the study period and were included in the Needs Rounds discussions. The monthly discussions led to 190 referrals to palliative care specialists and 231 advance care plans.

The difference in QODD scores between intervention and care houses was 8.07 (95 percent confidence intervals [CI], 3.77–12.37; p<0.01), suggesting a significant effect of the Needs Rounds meetings. This analysis was adjusted for age, sex, comorbidities and level of compliance, among other potential confounders.

Needs Rounds also empowered staff. Scores in the Capacity to Adopt a Palliative Approach tool significantly increased 6 months after the intervention began, with a mean change value of 4.73 (95 percent CI, 2.73–6.72; p<0.01). There were no adverse events or unintended side effects reported.