Effects of Advance Care Planning on End-of-Life Indicators for Nursing Home Residents-An Experimental Study with a Retrospective Chart Review.

Advance care planning (ACP) has the potential to improve the outcomes of end-of-life care for residents in nursing homes. The aim of this study was to determine whether an ACP program was beneficial for nursing home residents by assessing end-of-life indicators. An experimental study with a retrospective chart review was conducted. In total, 37 residents in the intervention group participated in an institutional advance care planning program for 1 year, and their chart data over 1 year were collected following the completion of the program; 33 residents in the control group had died within 1 year before the start date of program, and their chart data were reviewed retrospectively. Chi-square and t tests were used to examine four indicators of the quality of end-of-life care. Compared with the control group, the intervention group had a higher proportion of do-not-resuscitate directives, hospice care before death, and deaths in the nursing home, and fewer hospitalizations and deaths in an emergency department. ACP programs may improve the quality of end-of-life care for nursing home residents in Taiwan. Further research across different long-term care facilities is warranted.

[Role Function and Policy Prospects of Long-Term Care Nurses in Taiwan: Evidence-Based Policy Recommendations of Professional Nursing Organizations].

Professional nursing organizations represent an important channel for the nursing profession to influence health policy, represent and protect the interests of nurses, and advocate for the further development of the profession. Facing the rapidly increasing aging population and emerging needs of long-term care in Taiwan, the Taiwan Nurses Association launched an integrated project to propose policy advice on the development of nursing in long-term care. In this paper, the relevant findings in the domestic and foreign literature are summarized to better define the role function and core competence of long-term care nurses. In addition, the current tasks, perceived competence, and training needs of nurses working in long term care settings are presented, and the consensus on various advocacy strategies are summarized. The findings presented in this study may be referenced when developing evidence-based policy recommendations related to education, practice, legal / regulatory amendments, and professional organizations.

Experiencing simulated aging improves knowledge of and attitudes toward aging.

Nursing assistants provide 90% of the functional and psychosocial care of older adults in nursing homes. Without knowledge of the normal physical changes of aging, it would be difficult to provide them with appropriate quality care. This quasi-experimental study aimed to test the effects of the Elderly Simulation Program on nursing assistants' knowledge about aging, attitudes toward older adults, and the motivation to care for older adults in nursing homes. The program has two parts: a 1-hour lecture about aging changes and a 1-hour simulation of the roles of an older adult, a caregiver, and a "rusher" (20 minutes for each role). A convenience sample of 83 full-time nursing assistants was recruited from nursing homes in Taiwan. The participants were assigned to an experimental (n = 43) or a control group (n = 40). The experimental group received the Elderly Simulation Program intervention, whereas the control group did not participate in any educational programs. Data were collected before the intervention and 4 wk after the program was completed. Results indicated that 4 wk after the intervention, the experimental group participants' knowledge about aging and attitudes toward older adults had significantly improved (all P < .001). The experimental group participants also had greater knowledge of aging than the control group at posttest (P < .001). It is recommended that the program be incorporated into the regular on-the-job continuing education of nursing assistants in long-term care facilities to enhance their knowledge about aging and their attitudes towards older adults.