title: Palliative care case conferences in long-term care: views of family members.
abstract: OBJECTIVE
  This paper examines the use of structured Palliative Care Case Conferences in long-term care. The issues families bring to the Palliative Care Case Conference, their level of distress prior to the conference, the extent to which these issues are addressed by staff and family satisfaction with this process are described.
  
  
  BACKGROUND
  In most developed countries, up to 30% of older people die in long-term care. A palliative approach generally refers to the resident and family as the 'unit of care'. Interventions, which include family in palliative care, are required in this setting.
  
  
  METHODS
  Descriptive and thematic results from the intervention arm of a pre-post, sequential mixed method study.
  
  
  METHODS
  Examination of documents of 32 resident/family dyads participating in a Palliative Care Case Conference, and interviews with the residents' family postintervention.
  
  
  RESULTS
  Main concerns raised by family members prior to a Palliative Care Case Conference were physical and medical needs, pain, end-of-life care planning and nutrition and hydration. Families rated a high level of concern, 7.5 on a 10-point rating scale, prior to the Palliative Care Case Conference. A formalised Palliative Care Case Conference process ensured issues relating to end-of-life care planning, pastoral care, pain and comfort and physical and medical needs were well documented by staff. Issues relating to care processes and the family role in care were less well documented. All families, interviewed postintervention, recommended Palliative Care Case Conferences; and over 90% of families felt their issues were addressed to their satisfaction. Families also reported an increased understanding of the resident's current and future care.
  
  
  CONCLUSIONS
  The Palliative Care Case Conference in long-term care provides an important platform for family to voice concerns. Palliative Care Case Conference documentation indicates that staff are attending to these issues, although more reference to concerns relating to care processes and the family role could be made.
  
  
  CONCLUSIONS
  Increased communication between staff and family, in the form of a Palliative Care Case Conference, may reduce stress, anxiety and unwanted hospitalisations during the palliative phase.
authors.affiliation: School of Nursing and Midwifery, The University of Queensland, Milton BC, Qld, Australia.|Blue Care Research and Practice Development Centre, The University of Queensland, Milton BC, Qld, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Parker
authors.affiliation: School of Nursing and Midwifery, The University of Queensland, Milton BC, Qld, Australia.|Blue Care Research and Practice Development Centre, The University of Queensland, Milton BC, Qld, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Clifton
authors.affiliation: School of Nursing and Midwifery, The University of Queensland, Milton BC, Qld, Australia.|Blue Care Research and Practice Development Centre, The University of Queensland, Milton BC, Qld, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Tuckett
authors.affiliation: Western Australia Department of Health, WA Cancer and Palliative Care Network, East Perth, WA, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Walker
authors.affiliation: Brisbane South Palliative Care Collaborative, Queensland Health, Griffith University School of Medicine, Eight Mile Plains, Qld, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Reymond
authors.affiliation: Western Australia Department of Health, WA Cancer and Palliative Care Network, East Perth, WA, Australia.
authors.forename: Teresa
authors.initials: T
authors.lastname: Prior
authors.affiliation: Brisbane South Palliative Care Collaborative, Queensland Health, Griffith University School of Medicine, Eight Mile Plains, Qld, Australia.
authors.forename: Kristien
authors.initials: K
authors.lastname: McAnelly
authors.affiliation: Southern Adelaide Palliative Services, Repatriation General Hospital, Daw Park, SA, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Jenkin
authors.affiliation: Brisbane South Palliative Care Collaborative, Queensland Health, Griffith University School of Medicine, Eight Mile Plains, Qld, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Israel
authors.affiliation: Western Australia Department of Health, WA Cancer and Palliative Care Network, East Perth, WA, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Greeve
authors.affiliation: Southern Adelaide Palliative Services, Repatriation General Hospital, Flinders University, Daw Park, SA, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Glaetzer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009752:Nutritional Status; D059408:Pain Management; D010166:Palliative Care; D000070659:Patient Comfort; D011368:Professional-Family Relations; D011788:Quality of Life
keywords: care homes; case management; family; palliative care