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News Release - Assessing the impact of advance medical care planning in long term care during the pandemic

Thursday, June 4, 2020

(June 4, 2020) Long-term care (LTC) residents are at risk of 'over-treatment' and poor quality end-of-life care during times of serious illness, such as a COVID-19 infection, shows new research from two studies from Queen’s University and McMaster University. 

Through surveys with families of LTC residents and physicians, this research focused on what could improve communication and documentation about what a LTC resident would want when they become seriously ill. 

It’s important to understand both sides of the conversation to address this care gap. The research team, led by Drs. Daren Heyland (Queen’s) and Henry Siu (McMaster), conducted two separate studies with over 30 LTC facilities pre-pandemic. 

During times of serious illness, LTC residents may need to rely on their loved ones to make decisions about their care at their end-of-life. This research found that most residents think their families will know what to do, and many don’t think they need an advanced medical care plan. However, not documenting goals and wishes for care can lead to residents receiving care that they wouldn’t want. 

The results show that clinicians initiate goals of care discussions only 10% of the time. The health care system needs to encourage all clinicians to start engaging with patients and documenting advance medical care planning discussions well before or during LTC admission, so that documentation is readily available and accessible for LTC workers. 

Quotes 

The COVID-19 pandemic has shined a spotlight on the many problems that are experienced in long-term care, which unfortunately have existed for many years, including family visiting privileges, communication and care planning, and adequacy of basic care provided to residents. 

Daren Heyland, Director, Clinical Research Evaluation Unit, Queen’s University 

Finding ways to improve goals of care conversations in LTC is particularly important during COVID-19.  Addressing clinician barriers to participating in these conversations with LTC residents and their substitute decision-makers is just one vital part of high-quality care. Ensuring the voice of LTC residents are central and not lost during times of serious illness and decision-making completes this equation,” 

Henry Siu, Assistant Professor, Department of Family Medicine, McMaster University 

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Media contacts
Anne Craig, Media Relations Officer 
613-533-2877 
anne.craig@queensu.ca 

Veronica McGuire, Media Relations 
Faculty of Health Sciences, McMaster University 
(905) 525-9140 x 22169 
vmcguir@mcmaster.ca

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