An exploration of advance care planning education delivered by hospice specialists to care home staff: a cross-sectional UK survey

Background: Uptake of advance care planning (planning future care) in care homes remains low. There is a sparsity of research exploring hospice-led advance care planning education delivered to care home staff. Aims: To explore and evaluate advance care planning education delivered by hospice specialists to care home staff in the United Kingdom. Methods: A cross-sectional online survey disseminated via national-organisations and social media from August 2023 to April 2024. Participants included staff working in care homes and hospices (registered nurses/healthcare-assistants/managers). Results: Eighty-eight valid responses were received. Most respondents working in care homes strongly agreed (56.6%) or agreed (35.8%) that education increased their knowledge and confidence when engaging in advance care planning. About 71.4% of hospice staff and 50.9% of care home staff noticed changes to advance care planning following the COVID-19 pandemic, which included earlier initiation of discussions, and more focus on resuscitation. Identified barriers included, short-staffing and high staff-turnover in care homes. Despite high commitment, a lack of funding and resource capacity hindered hospice staffs’ ability to provide education. Conclusion: Education delivered by hospice specialists is important in supporting care home staff to develop knowledge and confidence to engage in advance planning discussions. Future evaluative research is needed to measure the efficacy/sustainability of hospice-led advance care planning education.