New Findings from the Supportive Hospice Aged Residential Exchange (SHARE) project

Here’s an update from Dr Rosemary Frey on a new publication from the Supportive Hospice and Aged Residential Exchange (SHARE) project.

As is the case in other nations with increasingly older populations, New Zealand has experienced a shift in the level of acuity of residents in aged residential care (ARC)(1). The World Health Organisation (2015)(2) has further recognised the importance of improving palliative care delivery within this setting.  Research has also demonstrated a clear link between a well-educated and supported workforce and quality of resident care.(3) Internationally, education has been seen as the most effective way of optimising palliative care provision in ARC.(4) How to address this growing need?

In collaboration with two local hospices over the course of one year, Rosemary and the SHARE team evaluated a new reciprocal model of palliative care delivery  – Supportive Hospice Aged Residential Exchange (SHARE)(5) in 20 ARC facilities. SHARE is a new model of palliative care designed to integrate specialist palliative and aged residential care services. It includes focused palliative care needs assessment; clinical coaching and role modelling, which will help ARC and hospice staff, put new learning into practice. The goal of SHARE is to help clinical staff improve palliative care within ARC facilities and to improve hospice nurses knowledge and skill to care for frail older people.

Results from the one-year evaluation of the model are presented in a new article published in Kotuitui.(6) As part of the evaluation, the authors examined experiences of 59 healthcare professionals and 12 bereaved family members during SHARE through in-depth interviews.  Interview transcripts were analysed using the Theoretical Domains Framework (TDF)(7) in order to identify facilitators and challenges to SHARE implementation.

Findings from the study indicated that staff found value in hospice nurse visits in terms of knowledge and skills gained in palliative care as well as reinforcement for those skills. Likewise, the hospice nurses also reported improved confidence in their understanding of geriatric care. Family members perceived the care of their relative as good overall although the impact of resource constraints on care was also felt. Results thus highlighted the challenges inherent to implementation of the model within the context of the limited resources and high staff turnover common within ARC.

For more information and a copy of the paper, please contact Rosemary r.frey@auckland.ac.nz

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