Integrating a palliative care approach into nursing care homes for older people.

Societies throughout the world are ageing and the proportion of people over 85 years of age is increasingly rapidly. In many countries a significant number of frail older people live in nursing care homes and will develop palliative care needs as they approach the end of their lives. In the United Kingdom around one fifth of those who die each year do so in a care home. Many of these will be cared for by generalist nurses and doctors without specific skills and knowledge in end-of-life care. Following a one-year pilot of the introduction of a nursing home facilitator post to introduce the principles of a palliative care approach into three nursing care homes for older people, the number of residents dying in hospital reduced by 25%.