Grant: Project Grant

Nursing homes are important sites of care for people who can no longer live safely in their own homes. The majority of people who enter a nursing home will die there, meaning that nursing homes should be experts in providing quality end of life care; yet, nursing home residents at the end of life often receive aggressive treatments that provide little benefit (such as use of certain medications or physical restraints) and they frequently suffer from distressing yet treatable symptoms (such as pain or shortness of breath). Accurately measuring and monitoring such care practices and distressing symptoms is important to reduce their occurrence and improve quality end of life care in nursing homes. Most provinces mandate the use of a clinical assessment tool called the Resident Assessment Instrument - Minimum Data Set 2.0 (RAI-MDS 2.0), which is regularly used to monitor overall quality; however, the tool is not regularly used to monitor quality of care at the end of life, specifically. In this research project, we will partner with care staff, decision makers, and nursing home residents and their families to study the modifiable symptoms and inappropriate care practices experienced by residents in Canadian nursing homes during the last year of life. Together with our partners, we will identify priority symptoms and practices for quality monitoring and will use RAI-MDS 2.0 data to develop quality measures for these priorities. The goal is to develop a new set of quality measures that can be used by different groups (including residents and their families, nursing home administrators and staff, and decision makers) to understand the quality of care at end of life provided in nursing homes and identify opportunities for improvement.