PhD research Anne Wichmann
Discussions about what residents in care and nursing homes still want or need in their final phase of life contribute to shorter hospital admissions, an analysis of these admissions shows. These conversations also lead to a higher quality of life in the final phase of life, indicate directly involved nurses. Anne Wichmann of Radboudumc investigated where these conversations between patients and care providers led. She received her PhD on November 16.
Improve quality of life
Palliative care is care aimed at improving the quality of life of patients and their loved ones, who are confronted with challenges associated with a life-threatening illness, be it physical, psychological, social or spiritual. The number of residents in long-term care institutions in need of this is increasing in the Western world. This entails higher costs for palliative care and raises the question of which types of palliative care work. One of the possible forms (interventions) is PACE (Palliative Care for Older People), set up by the European Union.
Researcher Anne Wichmann looked at the cost-effectiveness of this one-year care program. PACE is aimed at integrating palliative care in the daily work in nursing and care homes. 78 institutions from seven European countries participated, half of which received the intervention and the other half was the control group. Care personnel were trained to have conversations with residents about their wishes and needs in their final phase of life; this is called advance care planning.
Shorter time in the hospital
A striking result of Anne Wichmann’s study concerns the time that people were in hospital, if they ended up there in the last month of their lives. It turned out that the people who were well prepared for their final stage of life through conversations with trained care providers were on average three days shorter in hospital than people with whom these conversations had not been conducted. The introduction of this form of palliative care has resulted in a significant reduction in costs due to shorter hospital admissions.
Higher quality of life
Moreover, the quality of life is minimally maintained, a publication in BMC Medicine in September. This study shows that the quality of life of those interviewed was rated better by direct caregivers. This became clear from the “Quality of Dying in Long Term CareQuestionnaire, which focuses on the topics preparatory tasks (recording wishes, etc.), personhood (the patient’s dignity) and closure (closing of life).
Anne Wichmann: “That was probably because the conversations with these people had already been conducted in the nursing home. They had spoken, often with their loved ones, with trained caregivers about how they envisioned their final stage of life, which was important to them. The questionnaire, which was completed by the most involved nurse, shows that people have been able to end their lives in a good way. They were prepared for it. ”
Source: Radboudumc
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