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http://hdl.handle.net/11434/1134
Title: | End of life care challenges for older people in sub-acute care. |
Epworth Authors: | Bloomer, Melissa Botti, Mari Hutchinson, Ana |
Other Authors: | Barnfield, J. Poon, P. Runacres, F. |
Keywords: | Aged Sub-Acute Care End of Life Care Care Plans Inpatient Deaths Rehabilitation Family Communication Patient Demographics Care Provision Falls Diseases of the Circulatory System Life Management Difficulty Comorbidity Care Transitions Multidisciplinary Team MDT Centre for Quality and Patient Safety Research - Epworth HealthCare Partnership Epworth/Deakin Centre for Clinical Nursing Research, Richmond, Victoria, Australia. |
Issue Date: | Jun-2017 |
Citation: | Epworth Research Institute Research Week 2017; Poster 2: pp 25 |
Conference Name: | Epworth Research Institute Research Week 2017 |
Conference Location: | Epworth Research Institute, Victoria, Australia |
Abstract: | INTRODUCTION: Despite the goals of sub-acute care to optimise patient functioning, many older patients will die in sub-acute care. METHOD: Conducted in an 183-bed sub-acute facility in metropolitan Melbourne, an audit was undertaken of 55 inpatient deaths from July 2015-June 2016. Patient demographics, diagnosis, care goals, care transitions and end of life care management data were collected. All clinician written entries related to the timing, nature and content of communication with next-of-kin; and entries related to care provision and decisions were collected. RESULTS: Numeric data were analysed descriptively. Of the 55 inpatient deaths, 55% were male, and 64% were aged 80 or over. 'Falls', 'Diseases of the circulatory system' and 'Problems related to life-management difficulty' were the top three reasons for admission. 43% also had comorbid diagnosis of cognitive impairment. Almost 48% of patients were admitted for 'Assessment', and 39% to 'Establish a safe discharge destination'. One patient was admitted for management of end-stage disease. Content analysis of the written entries of the multidisciplinary treatment team revealed that when dying patients were able to state their preference for end of life care, care goals were openly communicated and care was more coordinated. In all other cases, the use of vague or evasive language was found to impact communication between clinicians contributing to delays in care processes and decisions; also impacting next-of-kin's understanding and acceptance that the patient was dying. Cultural differences were not consistently accommodated, further compounding end of life care. CONCLUSION: Further work is needed to promote earlier acknowledgement and communication when a patient admitted to sub-acute care is dying rather than requiring rehabilitation; allowing for care plans and processes to be amended accordingly. |
URI: | http://hdl.handle.net/11434/1134 |
Type: | Conference Poster |
Affiliated Organisations: | Deakin University, Geelong Center for Quality and Patient Safety Research - Epworth HealthCare Partnership Center for Quality and Patient Safety Research - Monash Health Partnership Monash Health |
Type of Clinical Study or Trial: | Observational Study |
Appears in Collections: | Rehabilitation Research Month |
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