Improving Supportive End-of-Life Care in Long-Term Care: Exploring the Changing Role of Family Physicians in Care Teams

About the Project:

Many older adults are living the remainder of their lives in LTC. LTC residents are generally frail and vulnerable to increased risk of death and poor quality of life. Their care is often provided by a team of healthcare providers. How can we ensure all team members are working effectively together?

Nursing staff in LTC play an important role, making sure that residents nearing end-of-life are comfortable. However, it is unclear how to best involve physicians. Communication and the role of various team members are often unclear. Therefore, we aim to better understand and optimize this team.

To understand how care can be improved at end-of-life, we have talked to LTC residents and their families. We have also talked to nursing staff. We now plan to talk to physicians to learn their perspectives.

Based on these perspectives and the research available, we will generate a list of practices that can be used to improve the lives of LTC residents approaching end-of-life. We will ask residents, family members, and healthcare providers to come together to agree on the top practices for a care pathway, including agreement on team roles and responsibilities.

These top end-of-life practices will then to be implemented and evaluated in LTC. Hence, our findings are foundational to improving end-of-life care for older adults living in LTC with frailty and complex medical needs.

Project Team

Principal Investigators:

• Jayna Holroyd-Leduc, MD, FRCPC — University of Calgary
• Aynharan Sinnarajah, MD, MPH, CCFP(PC) — University of Calgary
• Lorraine Venturato, PhD — University of Calgary

Co-Investigators:

• Sharon Kaasalainen, RN, BScN, MSc, PhD — McMaster University
• Patrick Quail, MD — University of Calgary
• Sharon Straus, MD, FRCPC, MSc, HBSc — University of Toronto
• Tamara Sussman, PhD — McGill University

Collaborators:

• Mike Conroy, BA, MSA (Health) — Brenda Strafford Foundation
• Heather Hanson, PhD — Seniors Health Strategic Clinical Network

HQP:

• Patricia Harasym, PhD — University of Calgary

Project contact: Jayna Holroyd-Leduc — jayna.holroyd-leduc@ahs.ca

CAT2018-03

Keywords: older adults; frailty; long-term care; palliative; physicians; primary care; end-of-life