Physical and psychosocial benefits of an interdisciplinary end-of-life care model for older adults in residential care homes in Hong Kong

OBJECTIVES: Older adults residing in care homes will eventually require holistic end-of-life care (EoLC) that addresses not only physical symptoms but also psychological, social, spiritual and information needs. This study evaluated the Integrated Residential Home EoLC Support Teams (IRHEST) Program, an interdisciplinary service model to enhance EoLC in residential care settings. DESIGN: A single-arm, non-randomized, pre-post intervention multisite trial. SETTING: EoLC services in Residential Care Homes for the Elderly (RCHEs) in Hong Kong from 2022 to 2024. PARTICIPANTS: Older adults (n = 567) with a prognosis of 12 months or less, residing in RCHEs, and their caregivers. INTERVENTION: IRHEST employs specialized nurses and social workers to provide case supervision, direct services and staff training to enhance EoLC at participating RCHEs. MEASUREMENT: Patient physical symptoms, psychosocial distresses and information needs were assessed at baseline (T0), one month (T1) and three months (T2) after intake. Caregiver psychological distress and information needs were assessed at baseline and two months post-intervention (T3). RESULTS: Pre-post evaluations revealed significant reductions in physical symptoms, psychosocial-spiritual distresses and information insufficiency of patients in the first three months of service. Among caregivers, there were significant reductions in psychological distress and information needs. Patients with dementia had lower physical symptoms distress at baseline, and their improvements in the first three months of service were comparable to other patients. CONCLUSION: The Program may be an effective and scalable intervention in addressing patients' physical, psychosocial, spiritual and information needs, as well as psychological distress and information needs among caregivers in residential care settings.