BMC Palliative Care | Abstract | Evaluating the systematic implementation of the ‘Let Me Decide’ advance care planning programme in long term care through focus groups: staff perspectives

BMC Palliative Care 2015, 14:55

Background
The ‘Let Me Decide’ Advance Care Planning (LMD-ACP) programme offers a structured approach to End-of-Life (EoL) care planning in long-term care for residents with and without capacity to complete an advance care directive/plan. The programme was implemented in three homes in the South of Ireland, with a view to improving quality of care at end of life. This paper will present an evaluation of the systematic implementation of the LMD-ACP programme in the homes.

Methods
Focus groups were conducted with 15 Clinical Nurse Managers and two Directors of Nursing where the programme had been implemented. A semi-structured topic guide was used to direct questions that addressed implementation process, challenges implementing advance care planning, advantages/disadvantages and recommendations for the future. Data was analysed using manifest content analysis.

Results
Five key categories emerged, with 16 corresponding subcategories. These subcategories emerged as a result of 37 codes. Key benefits of the programme included enhancing communication, changing the care culture, promoting preference-based care and avoiding crisis decision making. Establishing capacity among residents and indecision were among the main challenges reported by staff.

Discussion
A number of recommendations were proposed by participants and included multi-disciplinary team involvement, and a blended approach to education on the topic. According to participants relationships with residents deepened, there was a more open and honest environment with family, end of life care focused more on symptom management, comfort and addressing spiritual care needs as opposed to crisis decision making and family conflict.

Conclusion
The introduction of the LMD-ACP programme enhanced the delivery of care in the long-term care sites and led to a more open and positive care environment.

via BMC Palliative Care | Abstract | Evaluating the systematic implementation of the ‘Let Me Decide’ advance care planning programme in long term care through focus groups: staff perspectives.

Building a Dementia Inclusive Society: Highlights From Recent Bupa UK Webinar (Bupa UK / DigitasLBi)

Dementia and Elderly Care News

Summary

The “Building a Dementia Friendly Society” webinar, hosted by Bupa UK, held on Tuesday October 20th 2015, arrived at the following conclusions:

  1. While the focus in the UK is on building a dementia-friendly society, we need to start thinking about dementia-inclusive societies.
  2. Education will eradicate stigma and prejudices around dementia.
  3. Dementia informed workplaces are crucial as the number of people with working age dementia is increasing.
  4. Concerns for carers of people living with dementia are primarily anxiety, agitation and sleeplessness (not memory loss per se).
  5. Assistive technology can help, but ethical issues exist.

Presented with permission from Bupa UK and DigitasLBi.

Full Text Link

Reference

Discussing dementia: building an inclusive society. [Online]: Bupa UK, November 3rd 2015.

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