HERE - Irish Hospice Foundation

The Irish Hospice Foundation
Grant Scheme A – Development Activities
Results of Annual Call 2015
The following were the successful projects under the IHF’s 2015 ‘Call for Applications’
under Grant Scheme A - Development Activities in Hospice/Palliative Care. Short
summaries of the projects follow the table.
Principal
applicant
Dr Suzanne
Timmons
Jean Barber
Aideen Lawlor
Diarmuid O’Coimin
and Bettina Korn
Project Title
2015
€
Demonstrate the benefit of SPC input for
people living with dementia using case
studies
Standardising the Nursing Home to Acute
Hospital transfer letter:
17000
SALT facilitate involvement of people
with dementia to be more active
participants in decision making process
around dysphagia management in end
stage dementia
Survey of Bereaved Relatives/Friends –
VOICES MaJam
5000
5000
5000
2016
€
SUCCESSFUL PROJECTS (3) – SUMMARIES:
DEMENTIA AND PALLIATIVE CARE
1. Demonstrate the benefit of SPC input for people living with dementia using case studies:
Dr Suzanne Timmons,Consultant Geriatrician & Senior Lecturer, Centre for Gerontology
and Rehabilitation (CGR), UCC @ St Finbarr’s Hospital, Cork
The development will have two complementary work packages:
1) Extending specialist palliative care services (SPC) to people with dementia in Cork
This will involve a pilot program to establish links between Cork palliative care services
(Marymount) and the following two groups: a) People with dementia in three Nursing
Homes (NH) in Cork, facilitated through a newly established dementia co-ordinator post;
b) People with dementia attending the Assessment and Treatment Centre’s Memory,
Memory Support, and Parkinson’s Disease clinics.
2) Evaluating the benefit of a palliative care approach for a person with dementia
This will occur across two sites, Dublin and Cork. Dublin data will be predominantly
retrospective, capturing the learning from the care of ten people with dementia who died
recently, under the care of the Mater /Dublin North City community geriatrician team. In
Cork, data will include: i) NH staff focus-groups for baseline needs assessment and final
evaluation of benefit and learning; ii) Interviews with patients/family members to acquire
feedback and perceived benefits of SPC involvement. Finally, between Cork and Dublin, six
detailed case studies will demonstrate good practice for people with dementia at end-oflife.
2. Standardising the Nursing Home to Acute Hospital transfer letter:
Jean Barber, Clinical Nurse Specialist St Michaels Hospital DunLaoghaire
There is no single standardised Nursing Home transfer letter available nationally in Ireland.
Some Nursing Homes send very detailed letters; others photocopy the patients care plan
and unfortunately a few Nursing Homes send transfer letters with very little information in
them. Hospital staff spend unnecessary time contacting Nursing Homes for pertinent
baseline information. Many medical and nursing decisions are based on this information.
The objective of this project is to ensure that the information that Nursing Homes send with
their patients on transfer to an acute hospital is relevant for the patients nursing and
medical assessments. It will also help in formulating the nursing care plan and ensure that
the patient receives a person centred approach to care. This one page document consists of
the usual personal and medical information plus basic baseline information. Significantly,
there is a section which requests information about the whether the patient has any specific
palliative care/ end of life needs or has a DNR order in place.
This transfer letter can be found on the homepage of the St Michaels Hospital website under
“Referral information”. It is also in the Medicine for the Elderly section of the St Vincent’s
University Hospital website and on the Epicare system for Nursing Homes.
3. SALT facilitate involvement of people with dementia to be more active participants in
decision making process around dysphagia management in end stage dementia
Aideen Lawlor, Speech & Language Therapy Manager, St. Mary’s Hospital, Phoenix Park,
A dementia specific unit in Phoenix Park Community Nursing Unit (PPCNU) is home for 25
residents who all have a diagnosis of dementia. The SLTs will show how these residents
could be facilitated in expressing their opinions and influencing decision making in relation
to both current and future dysphagia management. By conducting interviews, the resident
will have their say in the decision making process around their dysphagia management in
the future, particularly at the end stage of their life. Talking Mats, which is an evidence
based communication tool, will be used by the SLT carrying out this project to ascertain the
opinions of the people with dementia. The outcome of the Talking Mats can then be used as
evidence of the conversations with people with dementia and will become part of the
medical notes. If this project is successful, it will be rolled out to all residents in the PPCNU.
4. Survey of Bereaved Relatives/Friends – VOICES MaJam
Diarmuid O’Coimin End of Life Care Coordinator Mater Misericordiae University Hospital
Dublin and Bettina Korn End of Life Care Coordinator St. James’s Hospital Dublin
The Mater Hospital and St. James’s Hospital (North and South side of Dublin City) have
commenced a joint research project to survey bereaved relatives and friends on the
experience of end of life care in their respective hospitals. Commencing in May 2015,
approximately 400 bereaved relatives in each site will be asked to complete a postal survey
entitled VOICES MaJam, which has been adapted by the research team from the UK
(Addington-Hall, University of Southampton http://www.southampton.ac.uk/voices/about_voices/ ) for the Irish acute hospital setting.
The study aims to gather direct feedback on the care experiences at end of life for patients
and their family and friends. Secondly the survey findings will support a process of
continuous improvement in the care of persons at the end of life, including their families.
The Mater/St. James’s/Trinity/ UCD collaboration envisages that the VOICES MaJam survey
will be the first step towards the establishment of a standardized system of collecting and
processing views of bereaved relatives and friends in order to improve the quality of end of
life care in our hospitals. The tool will be made available to other acute hospitals sites upon
completion of the study.