Implementing, Evaluating, and Scaling Up of the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) Program

This study will evaluate the implementation of the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) program using a cross-jurisdictional, effectiveness-implementation type II hybrid design (dual testing of clinical and implementation interventions) to assess the implementation (feasibility, fidelity, reach, sustainability) and effectiveness (family satisfaction, staff knowledge and confidence implementing a palliative approach to care, hospital use).

Inclusion Criteria: * English-speaking LTC residents with a score of 50% or less on the Palliative Performance Scale. Exclusion Criteria: * Non-English speaking LTC residents * residents with a score of more than 50% on the Palliative Performance Scale.