Long-Term Care Project

The Research

The Long-Term Care Team will focus on tailoring, implementing, and evaluating a multi-faceted suite of ACP tools in four long-term care (LTC) settings in southern Ontario. Although death is a commonplace in LTC, palliative approaches to care, including ACP, are still rare in LTC environments in Canada and abroad.


Work to date:

This study builds on previous work which aimed at refining, implementing and evaluating a five component evidence-informed palliative program called Strengthening a Palliative Approach in Long-Term Care (SPA-LTC).  While the SPA-LTC program addresses many facets of a palliative approach to care, it does not include tools and mechanisms to support ACP within a LTC environment. Yet evidence is clear, including data from 18 focus groups with 117 participants in the SPA-LTC project, that while staff in LTC view ACP as important, they express discomfort around when and how to engage in pre-emptive end-of-life discussions. As a result, many residents are denied opportunities to participate in their own end-of-life planning, resulting in excessive use of hospital transfers and invasive medical care at the end of life.


Principal Investigators:


Sharon Kaasalainen, PhD, RN

McMaster University

Dr. Sharon Kaasalainen is an Associate Professor in the School of Nursing at McMaster University, an associate member of the Department of Family Medicine at McMaster, and an Honorary Professor at Queen’s University in Belfast. Dr. Kaasalainen obtained her Bachelor of Science in Nursing, and a Doctor of Philosophy in Clinical Health Sciences from McMaster University, and a Master’s of Science in Nursing from the University of Toronto. Her top three research interests are pain management and palliative care in long-term care; improving the quality of life for older adults living in long-term care; and advanced practice nursing roles in long-term care.


Tamara Sussman, PhD, MSW

McGill University

Photo of Tamara Sussman

Dr. Tamara Sussman is an Associate Professor in the School of Social Work at McGill University. She obtained her undergraduate and master’s degrees at McGill University, and a PhD in Social Work at the University of Toronto, followed by a Post-Doctoral Fellowship at the Murray Alzheimer Research and Education Program at the University of Waterloo.  Dr. Sussman’s  program of research focuses on how health services and systems impact older adults and their family members, including spousal careers’ experiences with home care; older adults’ and family members’ experiences with the transition into long-term care; barriers and facilitators to the delivery of effective interventions for depressed older adults and their care partners;  the needs and experiences of more marginalized older adults in long-term care such as previously homeless older adults and older adults identifying as gay, lesbian, bisexual and transgender (LGBT) and most recently improving the delivery of palliative care in long-term care.