Please select the eligibility criteria that correspond to the clinical trial below.
Title: Implementing, Evaluating, and Scaling Up of the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) Program
Brief Summary: 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).


Options:
A: 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.
B: Inclusion Criteria:

* Residents of both sex, aged 60 years or over
* Residents living in a nursing home participating in the study
* Residents living in the nursing home for 30 days or more
* Residents without diagnosed and documented dementia, identified as follows:

  * residents not identified by the French Healthcare system as suffering from dementia (ALD 15)
  * residents not benefiting from a specific care program or a specialized follow-up for dementia
  * residents for whom there is no appropriate investigation for dementia diagnosis in medical records
  * residents not taking specific drugs for dementia (Cholinesterase inhibitors and/or Memantine)
* Residents and their GP having received information about the study
* Residents and their GP having expressed their agreement to participate in the study

Exclusion Criteria:

* Residents aged less than 60 years
* Residents not living in a nursing home participating in study
* Residents living in nursing home for less than 30 days
* Residents with diagnosed and documented dementia, identified as follows:

  * residents Identified by the French Healthcare system as suffering from dementia (ALD 15)
  * residents benefiting from specific care programme or specialized follow-up for dementia
  * residents for whom there is appropriate investigation for dementia diagnosis in medical records
  * residents taking specific drugs for dementia (Cholinesterase inhibitors and/or Memantine)
* Residents and/or their GP who received no information about the study
* Residents and/or their GP having expressed their opposition to participate in the study
C: Inclusion Criteria:

1. Clinical Dementia Rating scale (CDR) 1 or higher.
2. Moderate to high grade of agitation defined by the NPI-NH agitation item as equal to or above six points.
3. Planned long-term stay in the nursing home, and a minimum of two weeks stay in the nursing home before inclusion.

Exclusion Criteria:

1.Terminal phase (life expectancy less than 4-6 weeks)
D: Inclusion Criteria:

* Inclusion criteria for nursing homes:

  1. the board of directors/the management express explicit motivation to participate in the study and agree to allocate at least a 0,10 FTE per week for at least two ACP Reference Person(s) per 30 to 40 nursing home beds, to carry out the tasks that are part of this project
  2. have at least 100 beds

Inclusion criteria for care staff in the nursing homes:

1. able to speak and understand Dutch.
2. work in a participating nursing home as either (head) nurse, care assistant, psychologist, physiotherapist, occupational therapist, social worker, animator, or reference person dementia/palliative care

Exclusion Criteria:

* Exclusion criteria for nursing homes:

  1. nursing homes have taken/are taking part in another research study that is evaluating palliative care services or communication strategies, currently or in the past 4 years
  2. they have - or are planning to develop during the foreseen duration of the trial - an extensive ACP policy, meaning that (i) all nursing home residents or their family (in principal) regularly receive ACP conversations (two conversations or more each year) or (ii) the nursing home is judged by the researchers as having explicit and detailed ACP guidelines available (corresponding to high-quality ACP procedures and practices)
  3. major organisational changes or physical changes to the facility (e.g. building activities or staff re-organisation) are planned or ongoing during the study period.

Answer: A