Skip to main content

Table 1 The six steps of the ‘PACE Steps to Success intervention’

From: Decreased costs and retained QoL due to the ‘PACE Steps to Success’ intervention in LTCFs: cost-effectiveness analysis of a randomized controlled trial

Step

Content of the step

Discussions as the end-of-life approaches

Advance care planning discussions with residents and/or families are conducted to elicit wishes and preferences around end-of-life care.

Assessment, care planning and review

A ‘Mapping Changes in Condition chart’ is used monthly by nurses and care assistants to plot changes (deterioration and improvement) in a resident’s physical condition.

Coordination of care

Using a Palliative Care Register, residents who are identified as expected to live less than 6 months are discussed in detail during monthly multidisciplinary review meetings. A summary sheet is sent to physicians who were not able to attend the meeting.

Delivery of high-quality care

Staff learns about symptom control and complex communication skills, with a focus on pain and depression.

Care in the last days of life

The Last Days of Life checklist prompts and guides the care in the last days of life, with a focus on recognizing dying, communication with family, regular assessment of symptoms, anticipatory medication prescription, hydration, and psychosocial and spiritual support.

Care after death

Reflective meetings following a death are held to support staff and encourage experiential learning.