Evaluating the impact of the systematic implementation of advance care directives and palliative care education on quality of care at end of life in long term care settings

It is essential that nursing home staff are equipped to provide high-quality end-of-life care, while it is also essential that the wishes of the older person about their care are taken into account. Many nursing home residents develop dementia, which can interfere with their ability to make healthcare decisions and to communicate these. Advance care planning is the process of planning ahead for ones future healthcare while one still has the ability to make and communicate these decisions. The advance care directive (ACD) enables a person to record their healthcare wishes in advance so that these are known should a time ever come when the person can no longer communicate or decide for themselves. For long-term care residents who have already lost the ability to make or communicate these decisions, it is important that the medical team involves the residents family in the care planning process so that what is known about the residents values, beliefs and wishes about healthcare can be taken into account when deciding on the most appropriate treatment. This study will find out if the advance care planning programme and a palliative care educational programme for staff has a positive impact on the quality of care at end-of-life. Both the staff and the family will be asked for their views on the quality of the dying and death experience, while measures will also be sought from the dying resident on their level of comfort and control. It is important that we understand the value and impact of advance care directives and advance planning in long term care settings prior to supporting a national policy on standard implementation.

Award Date
19 June 2014
Award Value
Principal Investigator
Professor D William Molloy
Host Institution
University College Cork
Health Research Awards