Abstract:
A major concern created by an aging population in New Zealand is the impact on the
demand for health and disability services. New Zealand statistics project that the
aging population of people aged 65 years and over will more than double in the next
decade. This has implications for palliative care providers including hospices and
hospitals because long-term inpatient care is not generally provided by hospitals and
hospices. When dying patients need long-term care, residential settings become an
option. The level of palliative care in these facilities is dependent on staff training and
numbers. In general, staff are not trained in palliative care, neither do they provide
the multidisciplinary facets that define palliative care as undertaken by hospices.
This paper describes a practice development initiative using storytelling as the vehicle
for introducing the concept of the Liverpool Care Pathway (LCP) for the dying patient
into residential aged care settings. With the emergence of a reflective paradigm in
nursing the concept of storytelling as a teaching/learning tool has grown. Many staff
in residential care settings come from diverse ethnic backgrounds where for some,
English is their second language. Storytelling therefore can be a useful approach for
learning because it can increase their communication skills.
The Liverpool Care Pathway for the dying patient is a model that can be translated
across care settings, hospice, hospital, and community. It can demonstrate a
framework that facilitates multiprofessional communication and documentation and
embraces local needs, culture and language to empower health care workers to
deliver high quality care to dying patients and their family/whanau and carers.
Successful implementation of the LCP into residential aged care settings will benefit
from a robust process of engagement where the object is to develop a relationships
with stakeholders, communicate effectively, problem solve, or bring about change.
This paper will also explore the role of a facilitator as an agent of change and discuss
how the interplay of evidence, context and facilitation can result in the successful
implementation of the LCP into residential aged care settings.