Barriers and Facilitators of Palliative Care Communication in Aged Residential Care(ARC):a New Zealand Example

Background:Due to population shifts in recent decades, the health of older people is an issue of growing concern in New Zealand. Indeed, internationally, New Zealand has the highest number of reported deaths in aged residential care (ARC) (38%). Effective communication is a key component of both ARC staff palliative care training and family understanding.  Lack of communication between facility staff, residents and their families can result in problems in implementing effective care plans thereby impacting on the quality of care provided. Working in collaboration with a local hospice, the Supportive Holistic Aged Residential Care Education (SHARE) intervention was designed to package and systematically foster palliative care knowledge transfer to clinical care staff.

Objective:We aimed to examine barriers and facilitators of palliative care communication in aged residential care (ARC) during a pilot of the SHARE intervention.

Method:The SHARE intervention was implemented in two ARC facilities for 6 months. Eight post-intervention interviews were conducted with management and staff to assess the impact of SHARE in improving palliative care communication.

Results:The intervention so far can be described as being effective in improving communication, especially in relation to keeping notes well documented and alerting registered nurses and health care assistants to resident weight gain and loss.  English as a second language for some staff members hampered communication with families.

Conclusion: Relationships between hospice and facility staff, and consequently facility staff and patients are seen as key to effective communication and to the success of SHARE.