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Tutorials

The role of the tutorials is to provide a platform for a more intensive scientific exchange amongst researchers interested in a particular topic and as a meeting point for the community. Tutorials complement the depth-oriented technical sessions by providing participants with broad overviews of emerging fields. A tutorial can be scheduled for 1.5 or 3 hours.



Implementing advance care directives in nursing homes using the Let Me Decide advance care directive


Lecturer

William Molloy
Centre for Gerontology and Rehabilitation, School of Medicine, UCC
Ireland
 
Brief Bio

The Centre for Gerontology and Rehabilitation (CGR), School of Medicine, U.C.C. is led by Prof David William Molloy, Geriatrician and Chair in Clinical Gerontology, and is based in St Finbarr’s Hospital. The Centre was established in September 2010 is funded by Atlantic Philanthropies with a specific remit to establish interdisciplinary teaching and learning in Gerontology, Rehabilitation and End of Life Care in UCC and to raise the standard of care of the elderly in the South of Ireland. Prof Molloy received his medical degree from University College Cork in 1977 and became a member of the Royal College of Physicians Ireland (RCPI) in 1980. He then moved to Canada where he was appointed Professor of Medicine at McMaster University (1988) and  St. Peter’s McMaster Chair in Aging (2002) where he remained until 2010 when he returned to Ireland to take up his position as Chair of Clinical Gerontology. Vastly experienced in the area of cognitive impairment, dementia and Alzheimer’s disease, Prof Molloy has a proven track record in successful grant applications, co-ordinating multi-centre studies and recruiting large numbers of patients for research. Since his arrival in U.C.C., the CGR has secured funding from a number of sources including the Health Research Board (HRB) and the Irish Hospice Foundation (IHF).  Prof Molloy is a co-investigator in NILVAD and PERSSILAA (EU-FP7 funded trials). A recognised expert on capacity he has published over 140 peer-reviewed articles and several books.  To promote the autonomy of the elderly, he wrote the advance health care directive, “Let Me Decide”.  It has had 25 editions and is published in several languages and has recently been published in Ireland for the first time.  

Abstract

This tutorial describes twenty years experience systematically implementing advance care directives in nursing homes in Canada and Ireland.
We have implemented advance care directives in a variety of different settings using pilots and randomised trials. The primary outcomes have been satisfaction with health care, economic analysis and quality of death and dying in these settings.
We have books, standardised workshops, implementation manuals. videos, workshops and on line training program we use to educate staff.
We measure quality of death and dying with the QODD, Staff `Perception of End of Life care (SPELE) chart reviews and self reports by patients where possible..


Keywords

advance care directives, nursing homes

Results

The majority of staff, residents and families complete directives
We reduce mortality, reduce hospitalisation and improve the quality of care.
Systematic implementation of advance care directives is feasible and well received but staff and residents in long term care institutions in Canada, Australia and Ireland.


Discussion

More and more we are using on line training because it is more accessible and favoured by staff because to the increased felexibllity.

Secretariat Contacts
e-mail: ict4ageingwell.secretariat@insticc.org

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