Improving palliative care for older people in care homes

People are living longer, however, the very old often have many health problems and disabilities which result in them living and eventually dying in care homes. Residents of such homes are highly likely to die there, making these places where palliative care is needed. Palliative care provides relief from pain and other distressing symptoms experienced by people reaching the end of life. Palliative care hopes to help people live as actively as possible until death, and their families cope with the illness and bereavement. The aim of this review was to see how effective palliative care interventions in care homes are, and to describe the outcome measures used in the studies. We found only three suitable studies (735 participants), all from the USA. There was little evidence that interventions to improve palliative care for older people in care homes improved outcomes for residents. One study found that palliative care increased bereaved family members' perceptions of the quality of care and another found lower discomfort for residents with dementia who were dying. There were problems with both of these findings. Two studies found that palliative care improved some of the ways in which care was given in the care home, however, we do not know if this resulted in better outcomes for residents. There is a need for more high quality research, particularly outside the USA.