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BMC Palliative Care
Published in: BMC Palliative Care 1/2020

Open Access 01-12-2020 | Elderly Care | Research article

Experiences with the Liverpool care pathway for the dying patient in nursing home residents: a mixed-method study to assess physicians’ and nurse practitioners’ perceptions

Authors: Maartje S. Klapwijk, Natashe Lemos Dekker, Monique A. A. Caljouw, Wilco P. Achterberg, Jenny T. van der Steen

Published in: BMC Palliative Care | Issue 1/2020

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Abstract

Background

The Liverpool care pathway for the dying patient (LCP) is a multidisciplinary tool developed for the dying phase for use in palliative care settings. The literature reports divergent experiences with its application in a nursing home setting related to its implementation and staff competencies. The aim of this study is to understand how the LCP is being used in the context of the nursing home, including for residents with dementia, and experienced from the perspectives of those responsible for medical treatment in nursing homes.

Methods

A mixed-methods approach was used, consisting of a survey followed by interviews. A link to a 9-item online survey with closed and open-ended questions was emailed to all physicians and nurse practitioners of 33 care organisations with nursing homes in three regions of the Netherlands (North, West and South). In addition, 10 respondents with particularly positive or negative experiences were selected for semi-structured interviews.

Results

The survey was completed by 159 physicians and nurse practitioners. The respondents were very positive on the content and less positive on the use of the LCP, although they reported difficulties identifying the right time to start the LCP, especially in case of dementia. Also using the LCP was more complicated after the implementation of the electronic health record. The LCP was judged to be a marker of quality for the assessment of symptoms in the dying phase and communication with relatives.

Conclusion

An instrument that prompts regular assessment of a dying person was perceived by those responsible for (medical) care to contribute to good care. As such, the LCP was valued, but there was a clear need to start it earlier than in the last days or hours of life, a need for a shorter version, and for integration of the LCP in the electronic health record. Regular assessments with an instrument that focusses on quality of care and good symptom control can improve palliative care for nursing home residents with and without dementia.
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Metadata
Title
Experiences with the Liverpool care pathway for the dying patient in nursing home residents: a mixed-method study to assess physicians’ and nurse practitioners’ perceptions
Authors
Maartje S. Klapwijk
Natashe Lemos Dekker
Monique A. A. Caljouw
Wilco P. Achterberg
Jenny T. van der Steen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2020
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-020-00686-y

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