A $1.5 million Health Canada grant is allowing a McMaster nursing expert to support the long-term care sector in implementing a palliative approach to care that could benefit thousands of Canadians.

Researcher Sharon Kaasalainen will build a repository of tools for reforming palliative care in long-term care (LTC) facilities, including training more staff, promoting program development and capacity building; and consolidating these resources in an accessible national database.

She said that COVID-19, which proved lethal for LTC residents, laid bare major deficiencies in the existing care system. These included chronic staffing shortages, a lack of awareness around patients’ preferences and a negative perception of LTC facilities as ‘death houses.’ Ongoing personnel shortages also mean existing staff are unable to attend education or training sessions around palliative care.

“Most long-term care homes currently do not have a formal palliative program and changing this is a key objective,” said Kaasalainen, professor and the Gladys Sharpe Chair in Nursing at McMaster’s School of Nursing.

“A good program must put families and residents front and centre in decision-making, made to feel like part of the team and actively supported by staff in preparing for end-of-life care.

“In our previous work, we witnessed some truly horrible deaths and saw families suffer a lot of guilt after residents died. We all want families to feel that they made the right choices without any regrets. There’s so much more we can do to better support residents and families.”

Despite the ongoing stigma around LTC homes and the avoidance of talking and death and dying, Kaasalainen said residents themselves are often ready to have such conversations, but it is those around them that are reluctant.

To help such residents, Kaasalainen said that a strong LTC palliative program should include more and better trained staff who can help residents make better-informed choices. This should be backed up by a strong leadership team and ample community resources.

“This grant from the federal government is the first step in building a one-stop shop for tools and training resources that LTC homes can access to implement comprehensive palliative care programs,” said Kaasalainen.

“My research will have a direct and quick impact on practice and policy as we have a longstanding advisory board with clinicians, regional decision-makers, and professional organizations. Moreover, our research is a knowledge translation project so the purpose of it is to have a significant impact on both practice and policy.”

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