This project aims to achieve excellence in end of life care for people with dementia living in nursing homes. This will be achieved through Specialist Palliative Care Clinical Nurse Specialist (SPC CNS) mentoring of care home staff. The SPC CNS will work in a ‘hands on’ capacity in nursing homes to model good practice and mentor staff. Nursing home staff will be offered a reciprocal ‘hands on’ experience within the hospice in patient unit.

The innovations adopted include the opportunity for experiential learning across the two care settings and allow mentorship of nursing home staff in palliative care, focusing on needs assessment, symptom management and quality end of life care; as well as specific skill development identified by the individual practitioner / nursing home and mutually agreed with the hospice.

The time scale is one year for the SPC CNS and administration funding. The hospice experiential learning would be available after project end to consolidate and enhance skill competency.

Anticipated outcomes

• Improved advanced care planning for all patients with dementia by demonstrating opportunities to open conversations and allow patients and carers to communicate their preferences and wishes.
• Improved assessment and symptom management of palliative care needs of all patients with advanced dementia in care homes.
• A key aspect to the project focus is recognition of pain, through use of dementia specific pain tools, acknowledging evidence shows it atypical presentation results in being undiagnosed in this patient group.
• Better deaths as evidenced through use LCP tools and audit of outcomes.
• Improved carer and relative experience of the end stages of the illness.
• Positive anticipatory grief work for carers.
• Reducing the risk of complex bereavement.
• Improved confidence in palliative care delivery by nursing home staff.

Progress update

This project is making a difference to the care homes involved. It is encouraging behavioural change and personalised hospice standard of care for people with dementia. The nurses and carers involved are finding it very helpful