End of Life Care in Nursing Homes: Understanding and Mapping Solutions

Project Duration

October 2007 - September 2008

Funder

The National End of Life Care Programme

Aims

• To identify the key drivers and barriers within the wider health and social care system influencing quality of end of life care in care homes with nursing for older people
• To identify the key drivers and barriers influencing quality of end of life care intrinsic to care homes with nursing for older people
• To develop practical guidance for the implementation of transferable solutions relating to the intrinsic and extrinsic factors which influence quality of end of life care in care homes with nursing for older people

Methods

A mixed methods design was employed, consisting of two in depth case studies of care homes and a complementary survey of 180 nursing homes surrounding the case study sites (90 surrounding each site).

Outcomes and Findings

This study is now complete. Findings demonstrate that nursing homes are part of a larger care system and the quality of their interrelationships with the various parts of that system determines the quality of end of life care they can provide. If a nursing home cannot access support externally, they have to work in isolation to provide end of life care and are the often the sole advocate for the residents in their care. Further, if a nursing home is unaware of specific support available in the wider system, absence of support may not be recognized and acknowledged, and their isolation and lack of confidence is compounded.