European Geriatric Medicine - Supplement 1 - Volume 7 - October 2016

118 / 290

P-314
Advance Care Planning (ACP) as exit strategy beyond frailty:
respecting View of the Patient, Integrated Care System Planning
Association/Assembly (VIP-AA) and Preventing, Avoiding,
Postponing or Reducing Frailty Program (PAPRFP) in Japan
K. Senda, S. Satake, M. Nishikawa, S. Takanashi, S. Sakakibara,
K. Kinoshita, Y. Iida, I. Kondo, H. Endo, H. Miura. National Center for
Geriatrics and Gerontology, Obu, Japan
Introduction: Continuous discussion of advance care planning (ACP)
between patient and care team throughout from pre-frailty to end-of-
life (EOL), is a fundamental of EOL care (EOLC) standing at the view of
the patient. That is consistent with patient-centered care principle.
Methods: Organizing-committee (OC) for Preventing, Avoiding,
Postponing or Reducing Frailty Program (PAPRFP) for community
dwelling seniors and outpatients in National Center for Geriatrics and
Gerontology, was established in February 2014. Respecting View of the
Patient, Integrated Community Care System Planning Association/
Assembly (VIP-AA) was founded in 2015 and held inter-disciplinary
seminars for ACP promotion, for 3 times with pioneers in EOLC
standing at the view of the patient in 2015, and once for local health
and long-term care community in 2016.
Results: Pilot study group of PAPRFP was consisted of 21 female and
14 male; 78.2 ± 6.7 years. Participants were satisfied with PAPRFP
contents and interested in advanced course. OC recognized serious
needs of senior people nearing frailty for ACP, because preventing
frailty has limitation. On VIP-AA seminars, 68 participants learned
ACP in Obu; 155, Kyoto; 53, Tokyo, 2015 and 48 participants in Obu,
March 2016. Almost every participant gave positive feedback and
agreed with promotion for ACP in Train-the-Trainer strategy.
Conclusions: ACP promotion could be an essential element of
“Integrated Community Care System for the Elderly ” to continue
living with a sense of security in the most aged society, Japan. VIP-AA
advocates that ACP is exit strategy beyond frailty and PAPRFP is
entrance strategy for high-quality EOLC initiating ACP.
P-315
Patients’ views on the impact of multidrug-resistant bacteria
(MRB) in end-of-life care – Results of a qualitative study using
principles of Grounded Theory
A. Sturm 1,2, C. Sieber 1,2. 1Institute for Biomedicine of Aging (IBA),
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg,
2Department of General Internal and Geriatric Medicine, Hospital of the
Order of St. John of God, Regensburg, Germany
Objectives: The impact of infection and colonization with MRB on
patients in palliative and geriatric wards is mostly unknown. Existing
research data from a general population cannot be transferred to a
population in need of end-of-life care. Therefore, an interdisciplinary
team realized “M-EndoL – MRSA in End-of Life Care ”. It aims at
developing a patient- and family-centered approach to handle MRB,
taking into account the needs of hospitalized patients, relatives,
professional caregivers and healthcare institutions. The study at hand
is a subproject that focuses on patients’ reports and aims at assessing
the impact of MRB as experienced by the patients.
Methods: Using a semi-structured questionnaire, we interviewed 43
patients in order to explore the consequences of MRB regarding
information, communication, ailments, therapy and contact precau-
tions. Verbatim transcripts were inductively analyzed using principles
of Grounded Theory. Additionally, we report insights of a focus group
discussion.
Results: The impact of MRB varies widely. It ranges from no impact
to individually experienced consequences relating to the patient´s
physical constitution, social-life and emotional state. The impact often
depends on a patient´s health status and MRB-history, main diagnosis
and family situation. As they experience the impact, patients copewith
this situation as individuals.
Conclusion: The results suggest individual approaches when deal-
ing with geriatric and palliative patients. Team members and
institutional stakeholders should be aware that patients might be
upset and even burdened by positive MRB-findings and the required
contact precautions. Patient’ s suggestions imply that they would
benefit from comprehensible information, empathic communication
and individual support.
The project is funded by the Bundesministerium für Bildung und
Forschung (BMBF: Versstud12-1-032). There are no conflicts of
interest to be reported.
P-316
What is the relationship between socio-economic status and
quality of end-of-life care? Preliminary results of cross-sectional
data from the PACE study
K. Szczerbińska1, A. Pac1, V. Kijowska1, A. Stodolska1, I. Barańska1,
H. Finne-Soveri2, G. Gambassi3, B. Onwuteaka-Philipsen4, S. Payne5,
N. Van Den Noortgate6,7, M. Vernooij-Dassen 8, L. Deliens6,7, L. Van Den
Block6, on behalf of the PACE group. 1Jagiellonian Univ. Medical College,
Poland; 2National Inst. for Health&Welfare, Finland; 3Univ. Cattolica del
Sacro Cuoro, Italy; 4EMGO, Expertise Center for Pall.Care, VU Univ.,
Netherlands; 5Int. Observatory on End-of-Life Care, Lancaster Univ., UK;
6End-of-Life Care Research Group, Vrije Univ. Brussel (VUB) & Ghent Univ.,
7Ghent Univ. Hospital, Belgium; 8Radboud Univ. Medical Center,
Nijmegen, Netherlands
Introduction: PACE project (“Comparing the effectiveness of Palliative
Care for Elderly people in long-term care facilities in Europe” funded
by the EU 7th Frame Programme) was set up to assess effectiveness
and quality of end-of-life care for nursing home (NH) residents across
European countries: Belgium, Finland, Italy, Netherlands, Poland and
United Kingdom.
Objectives: The aim of this analysis is to study the relationship
between socio-economic status and quality of end-of-life care for NH
residents as assessed by their relatives.
Methods: The PACE study was conducted in 2015 by recruiting a
random sample of 322 NHs in 6 countries. A total of 1,622 deceased
residents were identified in 3 months’ period prior to contact with the
facilities. A questionnaire including items regarding socio-economic,
educational and demographic characteristics of deceased residents
and their relatives and measures of quality of end-of-life care
(Satisfaction with Care End-of-Life in Dementia scale) was sent to
the relatives.
Results: Across all countries, 840 (58.0%) relatives responded. Cross-
national analysis will be presented to show possible factors associated
with quality of end-of-life care. We will consider: age, gender, educa-
tion, financial situation, ethnicity and religion affiliation of deceased
NH residents, as well as characteristics of their relatives including:
age, gender, marital status, education, employment, religion affiliation,
relationship with resident, engagement in care, emotional, physical
and time burden.
Conclusions: Preliminary results will be presented of socio-economic
status of deceased nursing home residents and their relatives and
the association of these factors with quality of care at end of life as
assessed by relatives.
P-317
Systematic exposure experience as a condition for person-centered
care
K. Versluys1, S. Janssens2, M. Grypdonck3, R. Piers1, N. Van Den
Noortgate1, L. Vanlaere4. 1Department of Geriatric Medicine, Ghent
University Hospital, Ghent, 2Howest University of Applied Sciences,
Courtrai, 3Department of Public Health, University Center of Nursing and
Midwifery, Ghent University, Ghent, 4sTimul Ethics of Care Lab, Moorsele,
Belgium
Introduction: Person-centered care requires appropriate attitudes
of the caregivers. To foster these attitudes, a systematic exposure
experience for geriatric caregivers, using an open interview with a
patient followed by a reflection process, was set up.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S112