Aims: To trial a staff education and training program
designed to facilitate the adoption of a palliative care
approach for residents with end stage dementia in aged care
Methods: A cluster randomised controlled trial of 12 residential
aged care facilities in regional and rural setting with
530 residents in the intervention and 520 in the control
facilities. The intervention was delivering a tailor made evaluated
education tool and training program for aged care
staff conducted in two stages. The outcomes recorded were
Incidence of presentations to Emergency Department, hospital
admissions and mortality.
Results: Post intervention a signifi cant difference was
observed in Emergency presentations χ2 = 18.8, p < 0.0001;
OR = 0.44; 95% CI 0.31–0.65, 8.8% of intervention residents
versus 17.88% of control residents. (The intervention
group had a −5.88% reduction in Emergency presentations
and control group an increase of 14.6%.) Similar results
were found for the number of hospital admissions (intervention
6.9% versus control 11.3%), χ2 = 6.16, p < 0.013;
OR = 0.58 95%CI 0.38 to 0.89. The mortality was not
signifi cantly different p = 0.6.
Conclusions: A specifi c education and training program can
signifi cantly reduce emergency presentations and hospital
admissions without compromising resident care or mortality.
Training is a crucial and cost effective way to improve care
at end of life in dementia.