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Early integration of palliative care in a long-term care home: A telemedicine feasibility pilot study

Published online by Cambridge University Press:  18 February 2020

Giulia-Anna Perri Open the ORCID record for Giulia-Anna Perri [Opens in a new window] ,
Nada Abdel-Malek ,
Aysha Bandali ,
Haddas Grosbein  and
Sandra Gardner
Giulia-Anna Perri*
Affiliation:
Department of Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, Ontario, Canada Baycrest Health Sciences, University of Toronto, Toronto, Ontario, Canada
Nada Abdel-Malek
Affiliation:
Baycrest Health Sciences, University of Toronto, Toronto, Ontario, Canada Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Aysha Bandali
Affiliation:
Baycrest Health Sciences, University of Toronto, Toronto, Ontario, Canada
Haddas Grosbein
Affiliation:
Baycrest Health Sciences, University of Toronto, Toronto, Ontario, Canada
Sandra Gardner
Affiliation:
Baycrest Health Sciences, University of Toronto, Toronto, Ontario, Canada Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
*
Author for correspondence: Giulia-Anna Perri, Baycrest Health Sciences, 3560 Bathurst Street, North York, Ontario, CanadaM6A 2E1. E-mail: gperri@baycrest.org
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Abstract

Objective

Palliative care plays an essential role in enhancing the quality of life and quality of death for residents in long-term care homes (LTCHs). Access to palliative care specialists is one barrier to providing palliative care to LTCHs. This project focused on palliative telemedicine, specifically evaluating whether integration of early palliative care specialist consultation into an LTCH would be feasible through the implementation of videoconferencing during routine interdisciplinary care conferences.

Method

This was a mixed-methods evaluation of a pilot program implementation over 6 months, to integrate early palliative care into an LTCH. There were two pilot communities with a total of 61 residents. Resident demographics were collected by a chart review, and palliative telemedicine feasibility was evaluated using staff and family member surveys.

Results

For the 61 residents, the average age of the residents was 87 years, with 61% being female and 69% having dementia as the primary diagnosis. The mean CHESS (Change in Health, End-Stage Disease, Signs, and Symptoms) and ADL (Activities of Daily Living) scores were 0.8 and 4.0, respectively, with 54% having a Palliative Performance Scale score of 40. Seventeen clinical staff surveys on palliative teleconferences were completed with the majority rating their experience as high. Ten out of the 20 family members completed the palliative teleconference surveys, and the majority were generally satisfied with the experience and were willing to use it again. Clinical staff confidence in delivering palliative care through telemedicine significantly increased (P = 0.0021).

Significance of results

The results support the feasibility of videoconferencing as a means of palliative care provision. Despite technical issues, most clinical staff and families were satisfied with the videoconference and were willing to use it again. Early integration of palliative care specialist services into an LTCH through videoconferencing also led to improved self-rated confidence in the palliative approach to care by clinical staff.

Keywords

Long-term carePalliative CareTelemedicine
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Special Issue 4: Palliative and Supportive Care During The COVID-19 Pandemic , August 2020 , pp. 460 - 467
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Copyright
Copyright © Cambridge University Press 2020

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