54 Advance care planning in care homes; what is the value?

<h3>Background</h3> Newcastle Upon Tyne Hospitals Specialist Care Home Support Team (SCHST) works proactively to support patients in care homes to live and die well, to achieve this advance care planning is central. Twelve months is the average life expectancy for patients residing in a nursing home, with frailty being recognised as a leading cause of death in older people. This highlights the need for advance care planning for all patients in care home environments. <h3>Method</h3> A retrospective review of 250 patients who had advance care planning discussions and Emergency Healthcare Plan implemented by SCHST, patient outcomes were considered including; prevention of inappropriate hospital admissions and achieving preferred place of death for patients. <h3>Results</h3> 210 of 250 (84%) patients were not admitted to hospital after having EHCP put in place. Reason for admission for the remaining 40 of 250 (16%) patients were; required increased respiratory support with a chronic lung condition. following falls infection acute abdomen/surgical suspected stroke 116 patients had died at the time of audit. Place of care was 99 patients died in care home, 5 in hospice, 12 in hospital. Preferred place of care and death was documented on all EHCPs and achieved in 104 out of 116 (90%). <h3>Conclusion</h3> Advance care planning is imperative in supporting patients to receive the right care in the right place at the right time. This audit provides evidence that advance care planning and having an EHCP in place supports patients to avoid unnecessary hospital admissions and achieve preferred place of death. The outcome of this audit supports the need to extend this work and ensure opportunities for patients and their families or advocate to have opportunities to have discussions about priorities for future care and place of care and death.