Communication lapses during shift changes, limited staff training, and inadequate specialist support can lead to misdiagnosis and complications in long-term care (LTC) residents with heart failure, according to a new study from the University of Waterloo and the Schlegel-UW Research Institute for Aging.
The study published in the Canadian Journal on Aging, outlines 17 new recommendations that optimize care practices for heart failure in LTC, with the goal of improving resident quality of life and preventing emergency room visits.
“Identifying the barriers to optimal heart failure care in LTC is the first step towards improving care practices,” said Dr. George Heckman, Schlegel Research Chair in Geriatric Medicine and an associate professor in the Faculty of Applied Health Sciences at Waterloo. “At the forefront of these concerns is limited clinical knowledge around how to identify, document, discuss and treat at-risk patients.”
The findings are the result of a three-phase consultation process and expert panel that included front-line LTC staff, residents and family caregivers, and specialized physicians, nurses and pharmacists.
“Front-line staff want, and more importantly need, a better understanding of basic physiology and clinical skills specific to older and frail individuals with heart failure,” said Dr. Heckman. “Communication barriers between personal support workers, registered nursing staff and physicians interfere with information sharing that would otherwise lead to a more definitive and timely diagnosis and treatment.”
Currently, heart failure affects up to 20 per cent of residents in LTC homes. The study’s recommendations range from improving shift-change communication protocols to advance care planning and are designed for front-line caregivers, physicians, specialists and system-level professionals and administrators.
“These new guidelines are a very practical way of ensuring that patients in LTC receive the best possible care when it comes to heart failure,” said Dr. Heckman. “As the population ages, they will only become more critical.”
Heart failure is a leading cause of death in older adults. It affects over 26 million individuals annually.