WA22 “it’s hard to watch people die for a living”: embedding the palliative approach into the organisational culture of long term care homes using participatory action research

BACKGROUND: Long term care homes (LTC) in Canada have become a major location of death with 20% or more residents dying each year. Given the increasing age and frailty of residents, this is soon expected to increase to 40%. LTC has struggled to incorporate care of the dying into their day to day practice and culture because death is often absent from formalised policy and protocols. AIM: This workshop will share resources created during a 5 year participatory action research project in Ontario, Canada that aimed to improve the quality of life of people who were dying in long term care homes. METHODS: Through staff participation and empowerment, a process of organisational capacity development was undertaken. An extensive needs assessment was followed by creating an interprofessional palliative care resource team within each home. This team assessed the assets and gaps in their home and guided development of education, policy and clinical practices to address needs. Community partners with expertise in palliative care were engaged to support staff. RESULTS: A framework for palliative care in LTC integrates the palliative approach into the residents' journey from admission to death. Resources for organisational change were developed and organised into a toolkit that is unique to the LTC setting and context, and can be accessed at www.palliativealliance.ca CONCLUSION: The Quality Palliative Care in Long term Care Toolkit is the first of its kind in Canada. The toolkit can guide LTC management and staff through a process of culture change to incorporate a palliative approach to care.