Short summary

This project develops a palliative care intervention for nursing home residents with dementia, mental illness, or substance abuse issues. It equips staff with skills for early palliative care, including screening, planning, and conversations on end-of-life care. Using the ICECAP-SCM tool, success is measured by improved resident well-being and a 10% reduction in hospitalizations. The model will be adaptable for wider use while ensuring staff training and documented care plans.

Rationale

Palliative care for vulnerable and socially marginalized individuals, including those with severe mental illness, dementia, and substance abuse issues, remains a significant challenge in nursing homes. Traditional palliative approaches often do not fully address the complex needs of these residents, particularly those who exhibit aggressive behavior or have difficulty communicating their end-of-life preferences. Additionally, nursing home staff may lack the necessary competencies to provide adequate palliative care tailored to this group. Ensuring dignified and well-planned end-of-life care requires a proactive approach, integrating early screening, structured care planning, and improved communication between residents, relatives, and caregivers. By strengthening palliative competencies among healthcare staff, it is possible to enhance residents' quality of life and reduce unnecessary hospitalizations. Aim of the Study This project aims to develop and implement a flexible palliative care model for nursing home residents with mental illness, dementia, and substance abuse issues. The project will equip nursing home staff with the necessary skills to initiate early palliative interventions, facilitate conversations on end-of-life care, and create individualized care plans. Additionally, the study seeks to evaluate the effectiveness of this intervention by measuring improvements in resident well-being and reducing acute hospital admissions. Ultimately, the project aims to create a scalable model that can be adapted by other municipalities.

Description of the cohort

The study will include residents from Rosenlund Nursing Home, identified through the hospital records in the Sundhedsplatformen system using the address Mørkhøjvej 336, 2860 Søborg. The purpose is to analyze patient records to track their interactions with the healthcare system, including acute hospital admissions, planned admissions, and allocation of terminal care benefits. Journal data will be shared with the project with patient consent from Region Hovedstaden. The analysis will focus on identifying patient trajectories related to their healthcare contacts. The intervention will begin after January 30, 2025, and data from the project period will be compared with data from the previous year. This comparison will assess the number of acute admissions, planned admissions, and allocated terminal care benefits before and during the intervention. Inclusion Criteria Residents of Rosenlund Nursing Home ≥18 years old At least one hospital contact between January 1, 2024 - August 28, 2025 Data to Be Collected For both screening and final population selection, the following information is required: CPR number Planned hospital admissions (including dates) Acute hospital admissions (including dates) Hospital departments involved Diagnoses Allocation of terminal care benefits This data will help assess the impact of the intervention by comparing healthcare utilization before and after implementation.

Data and biological material

This study will collect data from patient records but will not involve the collection of biological material (e.g., blood, urine, feces, or saliva samples). The following categories of data will be included: Demographic data (e.g., age, gender, residency at Rosenlund Nursing Home) Medical history and diagnoses (e.g., dementia, psychiatric disorders, substance abuse) Hospital admissions Planned admissions (including dates and departments) Acute admissions (including dates and departments) Terminal care benefits (allocation of terminal support) Data from patient records (e.g., medical conditions, treatments, care plans) Data from national registries, including: The National Patient Registry (for hospital contacts and diagnoses) Additionally, questionnaire data will be collected using ICECAP-SCM, a tool evaluating aspects such as dignity, care quality, and end-of-life planning.

Collaborating researchers and departments

Clinical Institution

• REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care

REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care