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2023 Posters

Impact of Advance Care Planning on acute hospital admission rate and length of stay of nursing home residents in their last year of life

This study focused on Advance Care Planning (ACP) in Nursing Homes (NHs) to assess its impact on hospital admissions, length of stay (LOS), and concordance with ACP preferences. Previous research has shown that ACP can align care with patients' preferences and reduce healthcare utilization. The study aimed to fill the knowledge gap regarding ACP in NHs. Findings revealed that ACP discussions in NHs resulted in a slightly higher hospital admission rate but a shorter LOS. Concordance with ACP preferences was high. The study highlights the potential benefits of ACP in NHs, promoting patient-centered care and improved healthcare utilization.

Perception of Palliative Care in Nursing Homes Among Nursing
Home Staff

Palliative care is often lacking in long-term care (LTC) facilities due to inadequate support and training for nursing home (NH) staff. Gericare, a community palliative care program in Singapore, aims to empower NH nurses in end-of-life (EOL) care. However, little is known about NH staff's perceptions and challenges in delivering EOL care in the LTC setting. A qualitative study highlighted emotional difficulties faced by NH staff when providing EOL care due to the bonds formed with residents. Understanding NH staff's perceptions is crucial for developing effective education programs and training approaches to improve Palliative Care in LTC facilities.

Pain and Dyspnea Control of Palliative Patients in the Emergency Department

The number of patients with serious, life limiting illnesses presenting to emergency departments (ED) are expected to rise. 
Pain and dyspnoea are some of the most frequent reasons for patients with advanced cancer presenting to ED.
Early integration of palliative care into ED practice has been shown to improve quality of life of patients with optimal comfort measures and symptom control.
Opioids are effective in treating symptoms of dyspnoea and pain.
However, in a retrospective study conducted in a Singapore ED of patients who demised within 48 hours of registration, dyspnoea was the most common presenting symptom but opioids (Fentanyl or
morphine) were only administered in 22% of patients.

Healthcare Utilisation of Nursing Home Residents in the Last Year of Life: A GeriCare Study

The provision of palliative care (PC) and early identification of PC needs have been shown to improve quality of life and reduce acute healthcare utilization. GeriCare is an interventional program designed to screen for and provide PC to nursing home (NH) residents with PC needs. The aim of the study was to examine the effects of GeriCare interventions on NH residents in their last year of life. The study aimed to assess how the program impacted the quality of care and outcomes for NH residents nearing the end of life.

Evaluation of a Palliative Care Program in Nursing Homes

Nursing home (NH) residents often have unmet palliative needs and experience end-of-life (EOL) symptoms. Although efforts have been made to improve palliative care in NHs, the quality of EOL care and the quality of death have not been evaluated. GeriCare, a service in  Singapore, offers geriatric & palliative care to NH residents through education and clinical partnerships. The study aimed to compare the quality of death between residents who died in NHs and those who died in acute hospitals (AHs). The focus was on assessing the differences in EOL care and the overall experience of dying in these different settings.

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