COVID-19 National Long-Term Care Environmental Scan: Implementing a Palliative Approach to Care

In March and April 2021, we conducted a pan-Canadian environmental scan to examine current long-term care practice as it pertains to a palliative approach to care, including advance care planning and goals of care, in the environment of COVID-19.

The scan presents impactful findings from stakeholder interviews with leading authorities, including long-term care staff and representatives of provincial organizations that focus on end-of-life care. The results of this scan will inform the work of ACP in Canada and our partners as we continue to develop resources for long-term care practitioners across Canada.

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The need for a palliative approach in Long term care

Individuals in long-term care (LTC) who are reaching end-of-life have unique physical, emotional, social, psychological, and spiritual needs.

A palliative approach to care ensures these needs are being met in a compassionate way that enhances the quality of life, limits suffering and provides needed comfort.

Understanding a palliative approach to LTC

A palliative approach in long-term care (LTC) relies on evidence-based processes to provide high quality care for LTC residents living with chronic and life-limiting illnesses. This approach provides individuals with a seamless transition from chronic disease management to appropriate end-of-life planning and care. Working alongside health professionals and family members, individuals with a life-limiting or life-ending illness are involved throughout the illness trajectory. Care is rooted in open and honest conversations so residents can ensure their personal, spiritual and emotional concerns are heard and addressed.

Impact

Failure to proactively identify, discuss, and address end-of-life issues often leads to costly hospital stays and creates added stress or burden for families. Families and staff sometimes feel uncomfortable initiating early discussions about palliative care or what to do in the event of a change in health status. However, strengthening the capacity of long-term care (LTC) homes to engage in and support these discussions has real impact. Early research demonstrates that implementing a palliative approach to care in LTC leads to improved family satisfaction and a 55% reduction in emergency department visits for residents in their last year of life. As a result, more LTC residents can be supported to die at home, according to their wishes.

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