Models of Palliative Care in Long-Term Care: An Integrative Review

Background: Integrating palliative care services in long-term care lag because of the lack of support and resources. The results are fragmented care coordination, unavailability of palliative and hospice care services in long-term care facilities, lack of advanced care planning, inefficient referral to hospice hospitals, and underutilization of palliative care services in long-term care facilities. Objective: The aim of the review is to summarize available models of palliative care services in long-term care facilities. Methods: A literature search was conducted in June 2018. The databases included were CINAHL complete, MEDLINE complete, PubMed, and PsychINFO. Results: The search resulted in a total of 510 articles. Ten articles were included in the review. Three major categories identified about the models of palliative care in long-term care: palliative care based on setting, based on provider, and based on disease focused. Types of palliative care services include psychosocial services, care coordination, consultation, patient education, symptom management, spiritual support, and home visits. Most of the outcome reported in the included studies have been positive. However, the majority of the studies highlighted the lack of generalizability of the result because of various reasons such as inadequate sample, lack of statistical power, high attrition rate and poor methodology design. Conclusion: There is no consistent evidence to support which model is effective. the findings of this review demonstrate the necessity for a robust research design to compare various palliative care models.