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Oceanic Palliative Care Conference 2023
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End-of-Life Screening In Nursing Home Residents – A Proactive Approach

Poster Presentation

ePoster

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Presentation Description

Institution: St Andrew's Community Hospital - Singapore, Singapore

Background The number of deaths in nursing homes (NHs) are increasing globally and the situation in Singapore is no different.  Aim The Violet Program at Nursing Home (ViP@NH) is started by the St Andrew’s Community Hospital to improve the accessibility of palliative and end-of-life (EOL) care to NH residents.  A key element of the ViP@NH is the proactive approach used to identify residents who are at or near the end of life. Method All NH residents at two of St Andrew’s Nursing Homes (SANHs) were screened using the EOL Screening Form which was adapted from the Gold Standards Framework. For those residents screened to be eligible, but without an advance care plan (ACP), the team will initiate one before enrolment into the program. Those who are not eligible will either be scheduled for re-screening in 6 months or the NH staff will inform the ViP@NH team when there are changes in residents’ condition. Results In 2021, 113 (20%) residents were enrolled into the program after all 544 residents were screened. Of the 62 who died in that year, 92% died in the NH in accordance to their preferences. In 2022, 110 were enrolled and of the 89 who died that year, 98% of them died in NH in accordance to their preferences. Rates of ACP was 95% among those enrolled and 25% among those not yet enrolled. Discussion With proactive screening and identification of those who are eligible for EOL care, ACP can be established and care processes put in place to ensure the residents’ care preferences may be honored and their EOL care will be as dignified as possible. Conclusion Proactive EOL screening of NH residents improved their accessibility to palliative care and increased the likelihood of an ACP in place which will improve their quality of death.

Presenters

Authors

Authors

Ms Catherine Teo - St Andrew's Community Hospital , Dr Shaun Nathan - St Andrew's Community Hospital , Dr Angel Lee - St Andrew's Community Hospital , Dr Angeline Seah - St Andrew's Community Hospital , Ms Foong Yue Mok - St Andrew's Community Hospital , Ms Elaine Chew - St Andrew's Community Hospital

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