Providing palliative care for residents in LTC facilities: an analysis of routine data of LTC facilities in Lower Saxony, Germany

Table 1 Data pertaining to general facility structure and select PC indicators, collected from the nursing charts of deceased residents

	Collected data
Structural data
Facility	Region
Facility	Number of beds
Residents	Mean age at admission, in years
	Age structure (number of residents < 60, 60–69, 70–79, 80–89,90–99, > 100 years)
	Sex
	Care level, according to the German compulsory nursing insurance scheme^a
Staff	Number of staff
	Number of staff with
	• Basic palliative care training (40 h)
	• Advanced palliative care training (160 h)^b
Nursing chart data of residents who died in 2019
Personal data	Age
	Sex
	Date of admission
	Date of death
	Main diagnosis/diagnoses
	Care grade, according to the German compulsory nursing care insurance scheme
	Next of kin (known to the facility)
PC indicators	Specialized PC (yes/no; if yes, how long, in weeks?)
	Voluntary hospice service (yes/no; if yes, how long, in weeks?)
	Admission to hospital in the last 6 month of life (number of admissions, duration)
	Advance care planning offer (yes/no/yes, but offer rejected)^c
	Health care proxy (in written form, yes/no)
	Advance directive (in written form, yes/no)
	if yes: do not resuscitate order (yes/no; if yes: this request was complied: yes/no)

^aThis insurance covers the risk of becoming dependent on nursing care and attention, which may arise as a result of a serious accident, disease or old age. Nursing care insurance is obligatory for everyone with health insurance. Need for care and financing are determined via care grades, as follows: care grade 1: low level of impaired independence or capabilities; care grade 2: significant level of impaired independence or capabilities; care grade 3: serious level of impaired independence or capabilities; care grade 4: the most severe level of impaired independence or capabilities; and care grade 5: the most severe level of impaired independence or capabilities, alongside special long-term care requirements
^bIn Germany there are various trainings for palliative care competencies for LTC facility employees. A certified basic course of 40 h for all staff members and an add-on course of 160 h specifically for nurses[28]
^cAccording to law § 132 g part 3 SGB V

ISSN: 1472-684X