Evaluation of a Program Based on the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) Model

Background: Despite increased annual mortality in long-term care (LTC) homes, research has shown that palliative approaches to care are currently suboptimal in these settings. The purpose of this study was to evaluate resident, family, and staff outcomes associated with the Strengthening a Palliative Approach in LTC (SPA-LTC) program, developed to help encourage meaningful end-of-life discussions and planning. Methods: The study employs a mixed method design in four LTC homes across Southern Ontario. Data were collected from residents, families and staff of the LTC homes through chart reviews, surveys and interviews. Results: In total, 39 residents/families agreed to participate in the study. Positive intervention outcomes included a reduction in the proportion of emergency department use at end-of-life and hospital deaths for those participating in SPA-LTC, an improvement in interdisciplinary communication between staff, support for both families and staff involved, and increased family involvement in the care of residents. However, there were no significant pre-post differences in staff collaboration or comfort in providing end of life care. Conclusions: The benefits of SPA-LTC for families, residents and staff justify its continued use within LTC. Study results also suggest that certain enhancements of the program could further promote future integration of best practices within a palliative approach to care within the LTC context.