The Development of Palliative Care Model and Knowledge for Residents with Dementia in Long-Term Care Facilities

The population of dementia is a high risk group to be placed into institution. An inevitable consequence of dementia is the person’s condition will gradually deteriorate and functionally decline into the end of life stage. The long-term care institution should face the issues about rapidly raising the need of end-of-life care for persons with advanced dementia. However, the care models and researches on the palliative care for persons with advanced dementia are still deficiency in Taiwan. The core aim of this study is to examine the staffs who work in the long-term care facilities to take what actions in order to promote high quality end-of-life care for the residents with advanced dementia, and to evaluate the impact of these actions on practice and theoretical knowledge. The three years multisite action research guide study process. This study comprises three stages design. The first year is the exploratory stage. The purpose of this stage is to examine the role of long-term care facilities and staffs in relation to end-of-life care of residents with advanced dementia, and to identify problems that staffs’ experience in caring for residents with advanced dementia or with dying process. The second year is the facilitative stage; the goal is to develop the action program, and to examine what actions could successfully be implemented by staffs that in order to promote high quality palliative care for residents with advanced dementia. The third year is the evaluation stage. The purpose of this stage is to evaluate the impact of these actions, and to describe what can be learned from the process of using action research in order to develop knowledge and practice in relation to end-of-life care needs of residents with advanced dementia. One to three long-term care facilities that have dementia special care unit will be invited into this study. The study participants include the facility managers, directors of nursing, nursing head, directors of social worker, other care staffs (contracting physicians, nursing staff, social worker, and nursing assistants), residents with mild dementia, and the family caregivers of residents with advanced dementia. Data collection involves qualitative and quantitative method, using focus group and individual interviews, participant observation, and documentary analysis. Content analysis will be used to analyze the qualitative data. McNemar’s test and pair-t test will be used analyze quantitative data, to compare the difference of the quality of care of advanced dementia and nursing practices between pre-action and post-action. The study process will help the staffs to establish the culture fitting and practicable palliative care model for residents with advanced dementia in their selves long-term care facility. The study results will to be an evidence base for guiding clinical intervention and health policy decision making.

Project ID:PC10501-2041
External Project ID:MOST104-2314-B182-028-MY2