Do nursing homes for older people have the support they need to provide end-of-life care? : a mixed methods enquiry in England

Seymour, Jane and Kumar, Arun and Froggatt, Katherine (2011) Do nursing homes for older people have the support they need to provide end-of-life care? : a mixed methods enquiry in England. Palliative Medicine, 25 (2). pp. 125-138. ISSN 0269-2163

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Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for end-of-life care reported in the survey included variable support by general practitioners (GPs), reluctance among GPs to prescribe appropriate medication, lack of support from other agencies, lack of out of hours support, cost of syringe drivers and lack of access to training. Most care homes were implementing a care pathway. Those that were not rated their end-of-life care as in need of improvement or as average. The case studies suggest that critical factors in improving end-of-life care in nursing homes include developing clinical leadership, developing relationships with GPs, the support of ‘key’ external advocates and leverage of additional resources by adoption of care pathway tools.

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Journal Article
Journal or Publication Title:
Palliative Medicine
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This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (
Uncontrolled Keywords:
?? case studiesend-of-life caremixed methodsnursing homesolder peoplesurveysupportive and end of life careanesthesiology and pain medicinegeneral medicinemedicine(all) ??
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Deposited On:
18 Sep 2012 15:56
Last Modified:
16 Jul 2024 09:11