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1235 Post-death reflections of bereaved family members on quality of end-of-life care in residential aged care

bmjspcare · 2025-09-09 · canonical JSON source

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Aim To explore bereaved family members’ experiences of the end-of-life care received by their family member living in residential aged care.Background The provision of high-quality palliative and end-of-life care is crucial for residents of aged care facilities. Family member perspectives provide rich insights about end-of-life care provision. IMPART is an NHMRC-funded, cluster randomised trial designed to evaluate the effectiveness of an education and specialist telehealth support intervention for RACF staff on enabling preference-based care, reducing unplanned hospitalisation and improving end-of-life care quality. The trial commenced in 2023 with 10 Melbourne-based RACFs.Methods Family members of residents who died at participating facilities participated in a telephone survey about their relative’s end-of-life care, including satisfaction with care at the end of life (Satisfaction with Care at End of Life), comfort at end-of-life and end-of-life symptoms (Comfort Assessment in Dying), and perceived quality of death and impact of end-of-life care on families (ICECAP – Close Person Measure), with the option to provide open-ended responses for each care quality domain. Data were analysed using descriptive statistics and thematic analysis.Results Twenty-eight people completed the survey. Most respondents agreed that their family member received all necessary nursing assistance (93%), felt involved in decision-making (93%) and felt supported during their relative’s end-of-life period (96%). Qualitative analysis indicated perceived satisfaction with the compassionate care provided by RACF staff, and the proactive care and support from hospital in-reach teams. Less satisfaction was reported for end-of-life communication, continuity of care and RACF staff knowledge and training about specific end-of-life interventions and treatments.Discussion The research explores the authentic perspectives of bereaved family members’ lived experience of involvement in end-of-life care received by their family member living in residential aged care.Unique Contribution Family members are key sources of information on end-of-life care quality, contributing important data for evaluating the IMPART trial.Implications Family members provide valuable insights highlighting areas of quality care, as well as identifying gaps in practice, including optimising bidirectional communication. These findings can inform advance care planning and consent education and training. Families can provide feedback on the accessibility and effectiveness of end-of-life discussions to refine how care preferences are communicated and documented. This ensures providers can better address the needs of future families, making the end-of-life journey more person-centred, compassionate and supportive.