University of Pennsylvania, School of Nursing

Project Overview

The Center for Gerontologic Nursing Sciences at the University of Pennsylvania School of Nursing, in Philadelphia, teamed up with Genesis ElderCare, the nation's third largest long-term care provider, to evaluate a palliative care program to enhance the care provided to nursing home residents at the end of life.

Six Genesis nursing homes in Maryland participated in the project called Palliative Care in Nursing Homes. Two nursing homes served as control sites, providing care at a level above industry standards. At another two nursing homes, all staff received training in the concepts and practice of palliative care, emphasizing comfort as well as psychological, social and spiritual well-being. Another two nursing homes complemented this training with a team of palliative care professionals whose members focused on controlling symptoms and improving the patients’ quality of life. Staff were trained and encouraged to honor and nurture residents as whole persons.

The program studied the effect of the training and these special services on patients' and families' experiences as well as on the clinical outcomes and cost of care.

This innovative approach to improving the quality of life for long-term care patients and their loved ones was under the direction of Neville Strumpf, Ph.D., R.N., of the University of Pennsylvania School of Nursing, and Howard Tuch, M.D., medical director of Genesis ElderCare.

Tools

• Brochure "Palliative Care - Referral Information Guide"
• Brochure "Palliative Care - Family Information Guide"
• Attitudes Toward Death Survey
• Family Palliative Care Quality Survey A & B
• Palliative Care Screen
• Identification of Palliative Care Customer
• Minimum Data Set Trigger Guide for Palliative Care
• Pain Assessment Tool
• Palliative Care Worksheet
• Physical/Emotional Symptom Tracking Form
• Steps to Implement the Palliative Care Delivery Process
• Pain Audit for Customers with Cognitive Impairment/Dementia
• Teaching and Learning to Care: Training for Caregivers in Long-Term Care

Resources

• Bibliography (PDF 89 KB / 1 page)
  Download Acrobat Reader
• The Journal of Palliative Medicine (April 2003: Volume 6, No. 2) features an article about this demonstration project titled "Integrating Palliative Care into Nursing Homes".
• Integrating Palliative Care Into Nursing Homes
  Tuch H, Parrish P, Romer AL. Integrating palliative care into nursing homes: An interview with Howard Tuch and Pam Parrish. Innovations in End-of-Life Care. 2002;4(2).
• This demonstration project was also featured at the 2003 NHPCO 5th Clinical Team Conference:
  • Session 7: Clinical and Cultural Changes in Nursing Homes: Making Palliative Care a Routine Part of Care
    

After the Grant

Genesis ElderCare integrated palliative care policies and procedures into its nursing home policies, and expanded the program to include four additional nursing homes.

Contact Information

Principal Investigators:
Neville Strumpf, Ph.D., R.N., and Howard Tuch, M.D.
University of Pennsylvania
School of Nursing
420 Guardian Drive
Philadelphia, PA 19104-6096
Phone: 215.898.8802
Fax: 215.573.7492
Email: [email protected]
Email: [email protected]

Return to top

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families.