Planning for end-of-life puts long-term care residents’ wishes first

Death planning is a taboo topic in our society. 

When people move into long-term care (LTC) homes, their physical and mental health is assessed so staff can best support them and their needs. Planning for death is often overlooked, even though research shows that people report higher satisfaction around end-of-life care when they have a say in where and how they die.

In other words, many people want to be part of their death planning and doing so helps them die with dignity.

We work with long-term care homes to create end-of-life clinical support tools (CST) that help plan for death and facilitate conversations between LTC workers, residents, and their families around end-of-life care. We’ve found that seniors do want to talk about dying — they just don’t know how to start the conversation. 

Valley Manor Inc. is one of our long-term care partners. Gail Yantha, Director of Care at Valley Manor, says our palliative and end-of-life clinical support tools help staff develop a certain type of therapeutic relationship with residents. This relationship is key in order for seniors to speak openly about their wishes and care plan. 

“There’s a rapport that develops, and they become more interested in voicing [their thoughts] and they’re not so ashamed,” Yantha explains. “Residents are realists, they know what’s coming. They just don’t know how to express it.” 

Our Palliative and End-of-Life and End-of-Life clinical support tools assess a resident as a whole. Not only is their physical health considered, but their mental and emotional well-being, too. Yantha says physical ailments are often at the forefront of seniors care, but residents can experience pain in many different ways.  

“We have a lot of people that don’t have a good capacity. End-stage dementia [residents]… they experience pain like stage four cancer, but we’re not looking at it in that way,” she says.  

“We need to change our focus and really look at what people are going through and do it in a standardized fashion. We need to treat that pain and everything else that goes with it: not just the physical, but also the psychosocial and spiritual aspects. People suffer spiritual and emotional pain.”

Being able to express wishes around death is incredibly important. Not only does it lead to improved satisfaction around end-of-life care, but it also helps residents’ family members get on the same page. For instance, a child may not know that a parent can receive palliative care in their long-term care home without needing to be transferred to hospital. That can be a huge source of comfort for both residents and their families. 

“The tool acts as a catalyst and sets a spark for the dialogue between the family and the resident,” says Yantha. “Oftentimes, it’s very difficult for families to have that conversation. But [with the clinical support tools] you’re almost like a moderator.”

Michele Franklin, the Direct Care Nursing Coordinator at Valley Manor, agrees. She says that when someone moves into long-term care, the focus is often on their physical health needs. The clinical support tools help ensure planning for the best end-of-life care possible is also addressed. 

“I like the fact with the Palliative and End-of-Life tool, you’re looking at every dimension of a person and not just their body,” Franklin says.

“We need to focus on what they are facing health-wise, but also how we are going to meet their needs — health, social, and psychological — to bring them to a nice, dignified death.”