Advanced care planning – what does it mean to older people in the community setting?

The Florence Nightingale Research Scholarship has contributed towards the first year of a five year clinical PhD with the International End of Life Observatory with Lancaster University. The first year has been a steep learning curve as I have become familiar with on-line learning technology with my colleagues from across the globe. Each week during the term time we have linked as on-line as students from Australia, Slovenia, Bangladesh, Ghana, Canada, America and the UK, completing tasks and sharing experiences. I have completed the three modules required to pass the first year. These were:

  • Palliative Care: history, policy and practice.
  • Health Research: knowledge, evidence, policy and practice.
  • Research questions, methods and design.

The first two years of the PhD comprise of the taught element and as such the research itself will not be undertaken until year 3-5. During the modules I have begun to examine different approaches to answering the research question ‘What factors influence older people’s engaging with advanced care planning?’ An example of this is in the form of an essay within the main report.

RECOMMENDATIONS AND IMPLEMENTATION WITHIN THE WORKPLACE

During the past year I have completed teaching sessions with the local paramedics to discuss issues around advanced care planning, I have given talks to the local paramedic team about end of life issues including Preferred Place of Care, Advanced directives, resuscitation, ‘just in case drugs’, and end of life care at home. I plan to take this forward on a more formal basis with my employers, as it is increasingly important to work in partnership due to the increasing numbers of elderly frail, complex patients living at home. In addition, I have been actively taking part in the workplace journal club to share recent evidence with doctors and nurses. The PhD programme has refined my skills in critically appraising research and due to my on-going research interests I have been accepted to peer-review for the International Journal of Palliative Nursing. The Journal of Community Nursing has also asked me to submit an article on the role of the Community Matron in case management which I have discussed with the editor.

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