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Int J Older People Nurs. 2019 Jul 12:e12258. doi: 10.1111/opn.12258. [Epub ahead of print]

Quality of life of older persons in nursing homes after the implementation of a knowledge-based palliative care intervention.

Author information

1
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.

Abstract

BACKGROUND:

The goals of palliative care are to relieve suffering and promote quality of life. Palliative care for older persons has been less prioritised than palliative care for younger people with cancer, which may lead to unnecessary suffering and decreased quality of life at the final stage of life.

AIM:

To evaluate whether a palliative care intervention had any influence on the perceived quality of life of older persons (≥65 years).

METHODS:

This study was conducted as a complex intervention performed with an experimental crossover design. The intervention was implemented in 20 nursing homes, with a six-month intervention period in each nursing home. Twenty-three older persons (≥65 years) in the intervention group and 29 in the control group were interviewed using the WHOQOL-BREF and WHOQOL-OLD questionnaires at both baseline and follow-up. The collected data were analysed using the Wilcoxon signed-rank test to compare paired data between baseline and follow-up.

RESULTS:

In the intervention group, no statistically significant increases in quality of life were found. This result contrasted with the control group, which revealed statistically significant declines in quality of life at both the dimension and item levels. Accordingly, this study showed a trend of decreased health after nine months in both the intervention and control groups.

CONCLUSION:

It is reasonable to believe that quality of life decreases with age as part of the natural course of the ageing process. However, it seems that the palliative care approach of the intervention prevented unnecessary quality of life decline by supporting sensory abilities, autonomy and social participation among older persons in nursing homes. From the ageing perspective, it may not be realistic to strive for an increased quality of life in older people living in nursing homes; maybe the goal should be to delay or prevent reduced quality of life. Based on this perspective, the intervention prevented decline in quality of life in nursing home residents.

IMPLICATIONS FOR PRACTICE:

The high number of deaths shows the importance to identify palliative care needs in older persons at an early stage to prevent or delay deterioration of quality of life.

KEYWORDS:

ageing; education; nursing homes; palliative care; quality of life

PMID:
31298499
DOI:
10.1111/opn.12258
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