Studies show that care in the last days of life is far from optimal for older people dying in nursing homes. To date, few interventions exist that give guidance to health care providers in this setting on how to provide excellent care in the terminal phase.
1) To develop a Nursing Home Care Programme for the Last Days of Life, including an evidence-based clinical practice guideline for the pharmacological and non-pharmacological treatment of symptoms in the last days of life, a Care Guide for the Last Days of Life with recommendations for health care providers on recognizing dying, communication with family, regular assessment of symptoms, psychosocial and spiritual support, and interprofessional and transmural communication, and an implementation guide.
2) To investigate the implementation process of the Care Programme in nursing homes.
3) To study the effectiveness of the Care Programme in terms of improving the quality of end-of-life care and the quality of dying of nursing home residents.
We will develop the Care Programme by a) drafting the evidence-based clinical practice guideline following the steps of CEBAM, b) developing the Care Guide through multidisciplinary expert consultations, and c) drafting the evidence-based implementation guide together with stakeholders in nursing homes. We will investigate the implementation of the Care Programme and test its effectiveness in a pre- post action research study in 8 nursing homes. The study will be informed by Normalization Process Theory.