Advertisement

Palliative care education for care workers in aged care: A scoping review

      Abstract

      Background

      Globally, residential aged care is a common place to receive palliative care. Yet 70% of the workforce is made up of unregulated health care workers, many of whom have no formal palliative care education and report a lack of knowledge and ability to provide best practice palliative care.

      Question

      Does the provision of palliative care education to unregulated health care workers in residential aged care, improve knowledge, confidence, and ability to provide best practice care to residents with palliative care needs?

      Methods

      A literature search utilising health care databases CINAHL, MEDLINE, and AgeLine was conducted. Citations were screened against the inclusion criteria and the methodology from the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis, assisted in selecting articles that informed the research question.

      Findings

      Nine articles met the inclusion criteria. Four areas of interest were derived: (i) Palliative Care knowledge and confidence; (ii) Communication skills; (iii) Roles and responsibilities; (iv) Barriers to implementation and sustainability.

      Discussion

      Evidence suggests the provision of palliative care education to unregulated health care workers may be beneficial in imparting knowledge and confidence, ultimately resulting in an improved ability to provide best practice care. However, barriers within the aged care system may interfere with the implementation and sustainability of newly acquired knowledge. Limitations of the review include the unknown quality of the educational content provided.

      Conclusion

      Palliative care education is part of the solution to enhanced outcomes for aged care residents but is not the complete answer. Systemic industry change is required to achieve sustainable outcomes.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Collegian
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Arksey H.
        • O'Malley L.
        Scoping studies: Towards a methodological framework.
        International Journal of Social Research Methodology. 2005; 8: 19-32https://doi.org/10.1080/1364557032000119616
        • Australian Community Research
        Australian community research aged care survey.
        United Voice & Health Services Union, Sydney2019 (Retrieved 23 January 2021 Available from:)
      1. Australian Institute of Health and Welfare. (2021). Department of health 2020 aged care workforce census. Retrieved 31 October 2021 Available from: https://www.gen-agedcaredata.gov.au//Resources/Dashboards/Department-of-Health-2020-Aged-Care-Workforce-Cens

      2. Australian Primary Health Care Nurses Association. (2021). Unregulated health care workers (UHCW) position statement. Available from: https://www.apna.asn.au/

        • Beck I.
        • Jakobsson U.
        • Edberg A.-K.
        Applying a palliative care approach in residential care: Effects on nurse assistants' work situation.
        Palliative & Supportive Care. 2015; 13: 543-553https://doi.org/10.1017/S1478951513000783
        • Beck I.
        • Törnquist A.
        • Edberg A.-K.
        Nurse assistants' experience of an intervention focused on a palliative care approach for older people in residential care.
        International Journal of Older People Nursing. 2012; 9: 140-150https://doi.org/10.1111/j.1748-3743.2012.00343.x
        • Boomer C.
        • Ross M.
        • Dillon D.
        Improving caregivers experience: Enhancing end-of-life care for residents.
        International Practice Development Journal. 2019; 9: 1-14https://doi.org/10.19043/ipdj.91.005
        • Broad J.B.
        • Gott M.
        • Kim H.
        • Boyd M.
        • Chen H.
        • Connolly M.J.
        Where do people die? An international comparison of the percentage of deaths occurring in hospital and residential aged care settings in 45 populations, using published and available statistics.
        International Journal of Public Health. 2013; 58: 257-267https://doi.org/10.1007/s00038-012-0394-5
        • Chapman M.
        • Johnston N.
        • Lovell C.
        • Forbat L.
        • Liu W.M.
        Avoiding costly hospitalisation at end of life: Findings from a specialist palliative care pilot in residential care for older adults.
        BMJ Support Palliative Care. 2018; 8: 102-109https://doi.org/10.1136/bmjspcare-2015-001071
      3. Critical Appraisal Skills Programme. (2018). CASP qualitative checklist. Retrieved 16 January 2021 Available from: https://casp-uk.net/wp-content/uploads/2018/03/CASP-Qualitative-Checklist-2018_fillable_form.pdf

        • Cronin U.
        • McCarthy J.
        • Cornally N.
        The role, education, and experience of health care assistants in end-of-life care in long-term care: A scoping review.
        Journal of Gerontological Nursing. 2020; 46: 21-29https://doi.org/10.3928/19404921-20191022-01
        • Department of Health
        National palliative care strategy 2018.
        Australian Government, Canberra2018 (Retrieved 9 January 2021 Available from: )
        • Farrington C.J.
        Blended e-learning and end of life care in nursing homes: A small-scale mixed-methods case study.
        BMC Palliative Care. 2014; 13: 31https://doi.org/10.1186/1472-684x-13-31
        • Frey R.
        • Boyd M.
        • Foster S.
        • Robinson J.
        • Gott M.
        Necessary but not yet sufficient: A survey of aged residential care staff perceptions of palliative care communication, education and delivery.
        BMJ Supportive & Palliative Care. 2016; 6: 465-473https://doi.org/10.1136/bmjspcare-2015-000943
        • Fryer S.
        • Bellamy G.
        • Morgan T.
        • Gott M.
        "Sometimes I've gone home feeling that my voice hasn't been heard": A focus group study exploring the views and experiences of health care assistants when caring for dying residents.
        BMC Palliative Care. 2016; 15: 1-9https://doi.org/10.1186/s12904-016-0150-3
        • Holmberg B.
        • Hellström I.
        • Österlind J.
        End-of-life care in a nursing home: Assistant nurses' perspectives.
        Nursing Ethics. 2019; 26: 1721-1733https://doi.org/10.1177/0969733018779199
        • Hong Q.N.
        • Pluye P.
        • Fàbregues S.
        • Bartlett G.
        • Boardman F.
        • Cargo M.
        • O’Cathain A.
        Mixed methods appraisal tool (MMAT), version 2018.
        IC Canadian Intellectual Property Office, Canada2018
        • Jansen B.W.
        • Brazil K.
        • Passmore P.
        • Buchanan H.
        • Maxwell D.
        • McIlfatrick S.J.
        • Morgan S.M.
        • Watson M.
        • Parsons C.
        Exploring healthcare assistants' role and experience in pain assessment and management for people with advanced dementia towards the end of life: A qualitative study.
        BMC Palliative Care. 2017; 16: 6https://doi.org/10.1186/s12904-017-0184-1
        • Kaasalainen S.
        • Brazil K.
        • Kelley M.L.
        Building capacity in palliative care for personal support workers in long-term care through experiential learning.
        International Journal of Older People Nursing. 2012; 9: 151-158https://doi.org/10.1111/opn.12008
        • Karacsony S.
        • Chang E.
        • Johnson A.
        • Good A.
        • Edenborough M.
        Assessing nursing assistants' competency in palliative care: An evaluation tool.
        Nurse Education in Practice. 2018; 33: 70-76https://doi.org/10.1016/j.nepr.2018.09.001
        • Karacsony S.
        • Martyn J.
        • Rosenberg J.
        • Andrews S.
        Exploring the attitudes, beliefs, and values of the long-term care workforce towards palliative care: A qualitative evidence synthesis protocol.
        Progress in Palliative Care. 2022; 30: 94-100https://doi.org/10.1080/09699260.2021.2000807
        • Kortes-Miller K.
        • Jones-Bonofiglio K.
        • Hendrickson S.
        • Kelley M.L.
        Dying with carolyn: using simulation to improve communication skills of unregulated care providers working in long-term care.
        Journal of Applied Gerontology. 2016; 35: 1259-1278https://doi.org/10.1177/0733464815577139
        • Kunte V.
        • Johansen M.L.
        • Isenberg-Cohen S.
        Improving long-term care residents' outcomes by educating nursing staff on end-of-life communication.
        Journal of Hospice & Palliative Nursing. 2017; 19: 550-555https://doi.org/10.1097/NJH.0000000000000386
        • Malik M.
        • Chapman W.
        Education and training in end-of-life care for certified nursing assistants in long-term care.
        Journal of Continuing Education in Nursing. 2017; 48: 81-85https://doi.org/10.3928/00220124-20170119-09
        • Mavromaras K.
        • Isherwood L.
        • Crettenden A.
        • Flavel J.
        • Karmel T.
        • Moskos M.
        • Knight G.
        National aged care workforce census and survey – The aged care workforce, 2016.
        Australian Government Department of Health. Canberra. 2017; (Accessed 9 January 2021)
        • Mohlman W.L.
        • Dassel K.
        • Supiano K.P.
        • Caserta M.
        End-of-life education and discussions with assisted living certified nursing assistants.
        Journal of Gerontological Nursing. 2018; 44: 41-48https://doi.org/10.3928/00989134-20180327-01
      4. Nursing and Midwifery Board of Australia. (2020). Decision-making framework for nursing and midwifery. Available from: https://www.nursingmidwiferyboard.gov.au/CodesGuidelines-Statements/Frameworks.aspx

        • OECD
        Who cares? attracting and retaining care workers for the elderly OECD Health Policy Studies.
        OECD Publishing, Paris2020https://doi.org/10.1787/92c0ef68-en (Accessed 7 March 2022)
        • Palis A.
        • Quiros P.A.
        Adult learning principles and presentation pearls.
        Middle East African Journal of Ophthalmology. 2014; 21: 114-122https://doi.org/10.4103/0974-9233.129748
      5. Peters, Godfrey C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Chapter 11: Scoping reviews (2020 version). In: E. Aromataris & Z. Munn (Eds.). JBI manual for evidence synthesis. https://doi.org/10.46658/JBIMES-20-12

        • Pitman S.
        Evaluating a self-directed palliative care learning package for rural aged care workers: A pilot study.
        International Journal of Palliative Nursing. 2013; 19: 290-294https://doi.org/10.12968/ijpn.2013.19.6.290
      6. Royal Commission into Aged Care Quality and Safety. (2019). Interim report: Neglect. Retrieved 9 January 2021 Available from: https://agedcare.royalcommission.gov.au/publications/interim-report-volume-1

      7. TAFE Queensland. (2021). Certificate III in individula support - Aging. Retrieved 9 January 2021 Available from: https://tafeqld.edu.au/courses/18160/certificate-iii-in-individual-support

        • Tan A.K.J.
        Models of palliative care in long-term care: An integrative review [intergrative review].
        International Journal of Caring Sciences. 2019; 12 (Available from:): 892-900
        • Unroe K.T.
        • Cagle J.G.
        • Lane K.A.
        • Callahan C.M.
        • Miller S.C.
        Nursing home staff palliative care knowledge and practices: Results of a large survey of frontline workers.
        Journal of Pain and Symptom Management. 2015; 50: 622-629https://doi.org/10.1016/j.jpainsymman.2015.06.006