Palliative Care For Older People In Care Homes

In this work, contributors from nursing and medicine, from the social and health sciences, and from ethics and health planning provide an international perspective on key issues in relation to end-of-life care such as: assessment; loss, autonomy and the ethics of end-of-life decision making.

The ageing of society is becoming a major public health issue, posing challenges to social and health care structures in many countries. This book demonstrates the added value of palliative care which, although traditionally focused on cancer and the very end of life, can play a role in strengthening and complementing the care of older people. The book outlines the current state of worldwide policy work, research, and innovations in the field of public health and palliative care for older people and concludes with recommendations for policy and decision makers, at international and national level.

In our society, the overwhelming majority of people die in later life. They typically die slowly of chronic diseases, with multiple co-existing problems over long periods of time. They spend the majority of their final years at home, but many will die in hospitals or care homes. This book explores the possibilities for improving the care of older people dying in residential care and nursing homes. It argues that there are aspects of palliative care that, given the right circumstances, are transferable to dying people in settings that are not domestic or hospice based. End of Life in Care Homes describes what happens in nursing and residential care homes when a resident is dying, how carers cope, and the practical, health and emotional challenges that carers face on top of their day-to-day work. Based on detailed research from both the UK and US, the book shows how the situation can be improved.

Ageing populations mean that palliative and end of life care for older people must assume greater priority. Indeed, there is an urgent need to improve the experiences of older people at the end of life, given that they have been identified as the 'disadvantaged dying'. To date, models of care are underpinned by the ideals of specialist palliative care which were developed to meet the needs of predominantly middle-aged and 'young old' people, and evidence suggests these may not be adequate for the older population group. This book identifies ways forward for improving the end of life experiences of older people by taking an interdisciplinary and international approach. Providing a synergy between the currently disparate literature of gerontology and palliative care, a wide range of leading international experts contribute to discussions regarding priority areas in relation to ageing and end of life care. Some authors take a theoretical focus, others a very practical approach rooted in their clinical and research experience. The issues covered are diverse, as are the countries in which discussions are contextualised. Those working in both palliative care and gerontology will find the issues and advice discussed in this book hugely topical and of real practical value.

The teacher and gerontological social work scholar Mercedes Bern-Klug joins experts on nursing, law, medicine, sociology, and social work to provide a thorough understanding of nursing home palliative care. Their broad definition of palliative care treats comfort care as appropriate across the illness experience, not just at the end of life. Because a majority of nursing home residents are older adults facing multiple, advanced chronic conditions, this book is grounded in the provision of palliative care-especially palliative psychosocial care. Yet its practice recommendations can also be applied to other long-term care settings, such as assisted living. The contributors combine scholarship with practical wisdom in each chapter, mixing reviews of scholarly literature with insights gleaned from clinical practice. Chapter topics comply with the eight domains of palliative care developed by the National Consensus Project for Quality Palliative Care. Some focus on care of the resident, while others concern the resident's family. A special section addresses self-care for nursing home staff members, and another discusses nursing home rituals to mark the death of a resident. Bern-Klug concludes with an overview of the factors that will shape the future of palliative care for advanced chronic illness.

This book explores the meaning of quality of life in care for older persons and introduces the reader to their main concerns when receiving care. Based on qualitative research, it pays particular attention to the needs and requirements of older people, considering their individual family situations, social circumstances, values and lifestyles. Person-centred care is a way of providing nursing care that puts older people and their families at the core of all decisions, seeing each person as an individual, and working together to develop appropriate solutions. Following an introduction to the concept of quality of life in old age, the book reviews essential findings from worldwide research into the experiences of older people with regard to nursing care and the impact of these experiences on their quality of life. It investigates health promotion, care provided in nursing homes and assisted living facilities, and palliative care. Each chapter includes a brief introduction to the respective field of nursing care and the problems it has to deal with, concluding with a discussion of their implications for nursing practice in the respective field of care. In closing, the evidence from qualitative research is discussed in relation to current gerontological theories.

This book provides an unique resource for registered nurses working in hospice palliative care at home and for the community, outside of acute care settings and also incorporates literature related to palliative care in acute health care settings, as part of the overall services and supports required. Very few resources exist which specifically address hospice palliative care in the home setting, despite the fact that most palliative care occurs outside acute care settings and is primarily supported by unpaid family caregivers. An overview of the concerns for individuals and families, as well as specific nursing interventions, from all ages would be an excellent support for nursing students and practicing registered nurses alike. The book structure begins with a description of the goals and objectives of hospice palliative care and the nursing role in providing excellent supportive care. Chapters include research findings and specifically research completed by the authors in the areas of pediatric palliative care, palliative care for those with dementia, and the needs of family caregivers in bereavement. Interventions developed by the editors are provided in this book, such as the “Finding Balance Intervention” for bereaved caregivers; the “Reclaiming Yourself” tool for bereaved spouses of partners with dementia; and The Keeping Hope Possible Toolkit for families of children with life threatening and life limiting illnesses. The development and application of these theory-based interventions are also highlighted. Videos and vignettes written by family caregivers about what was helpful for them, provide a patient-and family-centered approach./div The book will benefit nursing students, educators and practicing registered nurses by providing information, theory, and evidence from research.