“All of us want assurance that the care our loved ones receive at end of life in residential care should be the best. The Irish Hospice Foundation (IHF) developed the Journey of Change programme to enable RCC (where 25% of people die each year) continually review and reflect the care they provide at end of life and introduce changes so that residents needs and their families are met in a truly holistic manner,” said according to Marie Lynch, Head of Healthcare programmes, Irish Hospice Foundation.
“We are very proud and grateful to the 100 RCC sites that participated in the first phase of the program, and particularly those who engaged in the evaluation, which has informed the next phase CEOL.”
This launch is the next step to introduce a national framework that will enable residential care centres keep a constant focused on providing compassion at end of life for residents, families and staff.
The Irish Hospice Foundation is pleased to announce our partnership with Beechfield Care Group, and we are delighted that Sarah McMickan CEO of Beechfield Care Group will formally launch the CEOL programme. We have agreed to work together to achieve the recognition amongst providers and policy makers that end-of-life care is a key component of quality care in nursing homes, and will be advocating for required investment to ensure this takes place.
“As CEO of Beechfield Care Group, I am very aware of how important it is for the residential care sector to continually seek improvements from the broadest perspective in the delivery of person centred care as residents approach the end of their life. For this reason I am delighted to launch the Irish Hospice Foundation CEOL programme; it will be very helpful to the sector to have a formal framework to support the delivery of compassionate care at end of life. This will become increasingly important with the change in Ireland’s demographics, and more people dying in residential care settings,” said Ms Mickan.
In Ireland there are currently over 28,000 people living in residential care, with approximately 7,000 people dying each year in these settings. As highlighted by the latest ERSI report (Projections of demand for healthcare in Ireland, 2015-2030) the number of people living in nursing homes is projected to increase by between 40 to 54 per cent by 2030.
Providing compassionate care for residents approaching the end of their life is a fundamental component of person-centred care. The CEOL Programme enables staff to continuously review, reflect and improve the end-of-life care they provide for residents, their families and the staff themselves. The programme embeds a continuous quality improvement approach and is built around the needs of the individual, with the resident always at the heart of every decision. Good end-of-life care is about being supported to live well until you die.
The pilot phase of the programme called ‘A Journey of Change’ ran from 2015 to 2016 in which over 100 RCC’s participated in. Dr Kathy Walsh (KW Research and Associates Ltd) conducted an independent evaluation of the Journey of Change programme and found that that it has the capacity to improve end-of-life care in participating residential care centres. “Where all elements of the Programme have been implemented, there have been significant changes in practice in relation to End-of-Life Care (EOLC) planning, at time of death and after death, with staff less likely to want to transfer patients to hospital toward end of life.” (Dr Kathy Walsh, 2017).
The feedback from staff has been extremely positive, with staff reporting that their confidence and communication skills in relation to end-of-life care had improved as a result of their participation in the Programme. The Journey of Change Evaluation report also identified staff development in term of recognising and providing caring to a dying person, accessing specialist palliative care earlier, accessing GP services earlier, pain management and supporting the person to die in the care centre as per the wishes of the resident.
Staff from St Oliver Plunkett Community Hospital who have participated in the programme have reported ‘because we are more confident talking to our residents about death and end of life, we have a lot more conversations with them about what they want, like and dislike. As a result, we know a lot more about what our residents want at end of life and we do our very best to give them what they want’.