title: Developing, implementing and evaluating an end of life care intervention.
abstract: Aim To develop, implement and evaluate a collaborative intervention in care homes seeking to increase the confidence and competence of staff in end of life care and enable more people to receive end of life care in their usual place of residence. Method A two-phase exploratory mixed methods design was used, evaluating the effect of an end of life care toolkit and associated training in care homes, facilitated by a specialist palliative care team. Six care homes in England were recruited to the intervention; 24 staff participated in discussion groups; 54 staff attended at least one training session; and pre- and post-intervention questionnaires were completed by 78 and 103 staff respectively. Results Staff confidence in receiving emotional and clinical support and managing end of life care symptoms increased post-intervention, but confidence in discussing death and dying with residents and relatives decreased. Audit data indicate greater reduction in the number of residents from participating care homes dying in hospital than those from comparison homes. Conclusion Collaborative end of life care interventions support care home staff to manage end of life and may enable residents to have choice about their place of death.
authors.affiliation: University of Surrey, Guildford.
authors.forename: Anna
authors.initials: A
authors.lastname: Cox
authors.affiliation: University of Surrey, Guildford.
authors.forename: Anne
authors.initials: A
authors.lastname: Arber
authors.affiliation: Woking and Sam Beare Hospices, Surrey.
authors.forename: Fiona
authors.initials: F
authors.lastname: Bailey
authors.affiliation: Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey.
authors.forename: Sue
authors.initials: S
authors.lastname: Dargan
authors.affiliation: Princess Alice Hospice, Esher, Surrey.
authors.forename: Craig
authors.initials: C
authors.lastname: Gannon
authors.affiliation: Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey.
authors.forename: Radcliffe
authors.initials: R
authors.lastname: Lisk
authors.affiliation: Chelsea and Westminster Hospital NHS Foundation Trust, Greater London.
authors.forename: Barry
authors.initials: B
authors.lastname: Quinn
authors.affiliation: Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey.
authors.forename: Jane
authors.initials: J
authors.lastname: Samarasinghe
authors.affiliation: Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey.
authors.forename: Martha
authors.initials: M
authors.lastname: Wrigley
authors.affiliation: University of Surrey, Guildford.
authors.forename: Ann
authors.initials: A
authors.lastname: Gallagher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015577:Geriatric Assessment; D006801:Humans; D009735:Nursing Homes; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013727:Terminal Care
keywords: care homes; collaborative working; end of life care; older people; preferred place of death