Lessons learnt and best practices in palliative care for nursing homes: PACE Steps to Success programme

Professor Sheila Payne, Professor Katherine Froggatt and Danni Collingridge Moore from the International Observatory on End of Life Care, Lancaster University, UK, describe their work in developing a new Massive Open Online Course (MOOC), which demonstrates how to implement the PACE Steps to Success programme to improve palliative care in nursing homes.

Left to right: Katherine Froggatt, Danni Collingridge Moore and Sheila Payne.

In an icy, snow-bound Europe, the prospect of spring may seem a long time ahead but it is coming. And with it, our thoughts turn to the welfare of older people, many of whom struggle to endure the long, cold winter days. For some older people, it will be their final few months of life as death rates tend to peak in late winter and early spring. For those older people who will spend their final phase of life in a care home, nursing home, or long-term care facility it’s important that care home staff know how to provide skilled and compassionate care.In this post, we explain how a new education and development programme, ‘PACE Steps to Success’, will help to improve palliative care for older people in nursing homes – and it’s completely free of charge!

Introducing the PACE Steps to Success programme

Over the last five years the Improving Palliative Care for Older People (PACE) project funded by the European Commission, has worked on several studies designed to investigate the needs of older people living in nursing homes (see our earlier blog posts). One aspect of our research has been to conduct a cluster randomised control trial in nursing homes in seven countries (Belgium, England, Finland, Italy, The Netherlands, Poland and Switzerland). In the trial, we tested a complex education and development intervention called the PACE Steps to Success programme, designed for nursing home staff and organisations to introduce a palliative care approach.

Our programme was based on the Routes to Success programme for care homes originally developed in England. It consisted of six sequential ‘Steps’ or topics that were essential foundations for providing palliative care to older people. They included:

  1. Discussions about current and future care (advance care planning conversations);
  2. Assessment and review of the resident’s physical and psychological condition;
  3. Monthly multi-disciplinary palliative care review meetings for all nursing home staff and health professionals that visited such as general practitioners;
  4. Delivery of high-quality palliative care (with a focus on symptoms of pain and depression);
  5. Care in the last days of life, and;
  6. Care after death using a staff reflective debriefing meeting.

Each Step was supported by appropriate ‘tools’, such as pain assessment measures for older people with or without dementia.

Information available in six languages …

In adapting and refining the PACE Steps to Success programme to an international context, we undertook careful cross-cultural adaptation processes to ensure that legal, social and healthcare factors had been considered. Then we prepared all the information required to learn about and implement the PACE programme, into a series of ‘information packs’. Following the trial, we once again revised and adapted the PACE programme ‘information pack’ to enable it to be used in other nursing homes. You can download the PACE Steps to Success programme information pack and resource tools in English, Dutch,  Finnish, Flemish, Italian and Polish. Click here to download. There will potentially be information in Japanese too.

As the snow melts and the spring arrives, the PACE Steps information has been developed into a free educational programme and we look forward to helping you to improve palliative care for older people in nursing homes by joining a Massive Open Online Course. The PACE MOOC course is designed for all care home staff and volunteers who work in or with care homes and it is also suitable for older people and their families wanting to learn more about care homes. It’s free of charge and begins on 1 April 2019. For more information or to enrol on the course, please visit the website.


This work was supported by the European Union’s Seventh Framework Programme (FP7/ 2007e 2013) under grant agreement 603111 (PACE project Palliative Care for Older People).

Links and resources


Members of PACE will be presenting Delivering Palliative Care in Ageing Populations: Comprehensive Interventions and Clinical Models in Parallel Session 7 (B) on Wednesday 23 May 2019 at 16.45 to 18.15. Please join us!

For more information about the 16th EAPC World Congress please visit the congress website. Register before 15 February to benefit from an Early Bird discount.

This entry was posted in EDUCATION & TRAINING, PACE, PATIENT & FAMILY CARE and tagged , , . Bookmark the permalink.

1 Response to Lessons learnt and best practices in palliative care for nursing homes: PACE Steps to Success programme

  1. thanks for this article, now home nursing is important and essential especially in corona various to safe our loved ones and it’s important for elderly care

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