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End-of-life Communication in Nursing Homes – Patient Preferences and Participation

What characterizes good end-of-life communication? This project aims to examine and enhance the existing practices and routines for Advance Care Planning in Norwegian nursing homes.

Nurse talking to an old man

Photo: Kristin Ellefsen/UiO

About the project

High quality in end-of-life care requires good clinical communication and systematic attempts to elicit the patient’s wishes and preferences. Inadequate end-of-life communication may result in deficient treatment and care (e.g. unaddressed needs and anxiety, lack of information, unnecessary hospitalization, insufficient pain control, coercive measures, conflicts with relatives and increased moral distress for the professionals).

Our investigation will be developed through a systematic literature review and through research in nursing homes - including staff, patients and relatives - in cooperation with national and international researchers. On the basis of these two steps, we will develop a guide for advance care planning for nursing home patients, containing a model for preparatory communication upon admission and guidance on how to follow up the advance care plan. The model will be tested in a sample of nursing homes.

Objectives

The overarching objective of the project is to improve the quality of end-of-life care in nursing homes, to promote autonomy and dignity of elderly people suffering from life-threatening illnesses and dementia, to involve the relatives in a better way, and to develop competence and awareness among all stakeholders, in particular the professionals.

Results

Background

There has been little previous research on how Advance Care Planning is understood and practiced, which factors may promote or inhibit preparatory communication, and how it is experienced by patients and relatives in Norwegian nursing homes.

Our study falls in three parts, using a combination of approaches, methods, and perspectives. Part one and two will contribute to identify fruitful strategies and best practices to be used in part three.

Sub-projects

  1. A systematic literature review
  2. A study of the practice of and experiences with ACP and shared decision making in Norwegian nursing homes
  3. Developing, implementing and evaluating Advance Care Planning

Financing

  • The Research Council of Norway

Start - Finish

  • 2013 - 2017
Published Feb. 28, 2014 2:45 PM - Last modified June 8, 2017 1:48 PM