b"PALLIATIVE CAREThe time is nowThe need for integration of specialist palliative care in long-term careBy Amit Arya & Nadine PersaudDr. Amit Arya Dr. Nadine PersaudL ong-term care serves as the finalleadership and research. The and debunking common myths related home for almost all residentsprogram focuses on a number of to palliative care.before their death, with ankey components.average length of stay of around twoInnovative researchyears in Canada. Most long-term careEnhancing clinical care Ongoing research includes a residents face progressive, incurableTo date, the program has provided on- retrospective chart review to examine illnesses such as dementia, frailty, heartsite specialist palliative care support tohealthcare outcomes for residents failure, lung disease and, less over 150 long-term care residents forin the program and a scoping often, cancer.symptom management and advancereview of Specialist Palliative Care care planning. Regular debriefing andInterventions in Long-Term Care. In Canada, the annual mortality rate support for nurses, personal supportThe Kensington Gardens has also in long-term care ranges from workers and social workers haveparticipated in research studies on 27% to 52.3%. Therefore, providingled to a better understanding of theimproving end-of-life prescribing of high-quality palliative care is crucial importance of early palliative care. Wesymptom management medications for long-term care residents. Palliative have also updated our end-of-life orderand implementing the RESPECT care aims to enhance quality of life set and have availability of a specialisttool, which uses big data to improve while living with serious illness. palliative care physician for telephoneprognostication, in order to guide Starting palliative care early in an illness,support from Monday to Friday advance care planning discussions.alongside other treatments like 8:00 a.m.5:00 p.m.dialysis or chemotherapy, rather thanFuture directionsjust at the end-of-life, can bring Advance care planning Looking ahead, the Specialist Palliative significant benefits. Many residents, along with theirCare Program aims to support other family, friends and caregivers, receivedlong-term care homes beyond Unfortunately, there are significantassistance with advance care planning,Kensington Gardens. Currently, the gaps in delivering palliative care inwhich involved open discussionsprogram has extended its services to long-term care. Data shows that 81%about the nature of a life-limiting illnessanother long-term care home in the of long-term care residents in Canadaas well as treatment options for thecity, with hopes of continued growth did not receive palliative care in theirfuture. Advance care planning plays anand improvement in palliative care for last year of life, and only one in eightimportant role in preparing residents,long-term care residents within the residents with advanced dementia sawsubstitute decision makers and staffToronto Region. LTCTa palliative care physician in their finalfor the future, given that the majority year. Consequently, long-term careof long-term care residents have residents frequently have undertreatednon-cancer illness, where a sudden symptoms and are often transferred todecline or worsening of health is notDr. Amit Arya is a Medical Direc-the hospital, even at the end of life.uncommon. The program encouragestor with the Specialist Palliative meaningful conversations focusedCare Outreach Program at Kens-The Kensington Gardens is a 350-bedon understanding the resident'sington Gardens, and Dr. Nadine long-term care home in downtownwishes, along with providing medicallyPersaud is the Senior Director, Toronto. In March 2021, a Specialistappropriate options for care. Client Services at Kensington Palliative Care Program was developedGardens and the Executive at Kensington Gardens led by Educational initiativesDr. Amit Arya, a palliative careA needs assessment was conductedDirector at Kensington Hospice. physician, and Dr. Nadine Persaud,for direct-care staff to understandPlease visit www.kensington-the Senior Director of Client Servicestheir palliative care education needs.health.org to learn more and and a palliative care social worker. Dr.Education is provided both at thecontact the authors to receive a Arya and Dr. Persaud aim to enhancebedside and in classrooms, addressingreferenced copy of the article. palliative care through education,staff interest in improving their skills 36 LONG TERM CARE TODAY Spring/Summer 2024"