Building resident and family understanding of care through ELDAC Linkages Program
A guest blog post by the team at Catholic Healthcares' St Hedwig Village
At St Hedwig Village, our aim is to provide the best quality holistic care for our residents, regardless of where they are on life’s journey. We’re located in Blacktown, Sydney, with 137 staff and with a co-located hostel and Memory Support Unit, plus two levels of high care aged care.
Palliative care has always been a priority for us: we support our dying residents with dignity and love, but we wanted to improve. In 2022, our regional manager told us about the ELDAC Linkages Program and encouraged us to apply.
We achieved several goals through the ELDAC project. For example, some staff said that they didn’t understand palliative care and felt uncomfortable talking about the end of life. We also had family reluctance to discuss advance care planning. Lots of residents remained ‘for CPR’ and wanted hospital admission when they deteriorated, but we wanted to provide their comfort care.
It fell to our registered nurses (RNs) to talk through these issues and explain what end-of-life care means, and we have really built these communication skills. Getting families on board remains a challenge at times (for example, some still won’t consider funeral directors even when death is imminent) but we’ve been able to reduce the number of residents ‘for CPR’ and we’re sending fewer people to hospital. Case conferences are helping – we’re able to agree and introduce comfort measures for residents in a timely way.
One resident’s family had completed their advance care plan (ACP) asking for hospital admission for any deterioration, but after a multi-disciplinary case review, we were able to explain the limited benefit of hospital care for their relative. Together, we were able to help bring the family to a place of understanding and acceptance. The resident’s son changed the ACP, detailing hospital admission only in event of fall resulting in fracture, otherwise for comfort care in place, which we were able to provide - a real result!
Our pain management has also improved – we pick up signs more quickly now and respond more promptly. For example, in the event of deterioration, we connect with the Nurse Practitioner or GP for medication management. This avoids resident distress or agitation. Escalating concerns wasn’t normal for our care workers, and now it is! We’ve implemented Stop-and-Watch and this has made staff feel more comfortable talking about their concerns.
Everyone has been educated on the Surefuser pump so we are better able to set up infusions in a timely way, and we’ve developed a palliative care kit for the resident’s room. This helps us engage family in end-of-life care.
We’re proud of our greater focus on spiritual care and mindfulness practices. Spirituality in Dying sessions were provided for our RNs and care staff to further embed a work culture on journeying with individual’s spirituality at end of life. Mindfulness sessions were offered with a focus on caring for the carers. The theme ‘Love and Kindness’ complemented our work in the ELDAC Linkages Program, and staff are more comfortable and confident in this space now. Our whole team adhered to Catholic Healthcares’ mission of promoting Integrity, Life and Spirituality for our residents through our work with the ELDAC project.
In summary, we’ve resolved the ‘fear factor’ around palliative and end-of-life care, building knowledge and confidence in our team, and promoting the simple need for love and comfort at the end of life.
More information on St Hedwig Village Residential Aged Care.