1.9.2 Improving palliative care in care homes: Evaluation of an end of life education programme for health care assistants (415)

Annie Topping, Director of the Centre for Health & Social Care, Nursing, University of Huddersfield, Huddersfield, United Kingdom Co authors: Vanessa Taylor, Lucy Zeigler a.e.topping@hud.ac.uk

Abstract:

Background:

The elderly are the group with the greatest health and social care needs in contemporary society. Palliative care focuses on the support of people as they live and die with life limiting illnesses. Palliative care needs in the elderly rarely arise from a single disease and are made more complex by the cumulative effects of ageing (Dowding and Homer 2000, NCPC 2005). Care homes in the UK, are increasingly the place where many older people live their last months, sometimes years, and are where 20% of the over 65s die. Much of the care is provided by health care assistants (HCAs). This study evaluated the impact of a two day palliative care educational programme delivered over a three year period to HCAs (n=963) working in care homes and other support agencies. The programme was commissioned to increase completion of National Vocational Qualifications (NVQ) in care undertaken by HCAs.

Aims:

This study set out to assess whether knowledge, attitudes and approach to the dying had changed after completion of the programme. Further if any changes were translated into improved care for residents and service users.

Methods:

Pre and post administration of an adapted version of the Palliative Care Quiz for Nurse (Ross et al 1996)
Completion of a post course questionnaire eliciting personal reflections on learning;
Focus group interviews undertaken with HCAs, RNs, and care managers
Telephone interviews with home managers, commissioners and other key stakeholders

Results:

Significant knowledge increase and personal and professional development was reported by the HCAs. The programme had little impact on uptake of NVQ units. The organisational culture emerged as the greatest challenge to influencing change.