Healthcare professionals' perspectives on implementing the Swedish palliative care guide in geriatrics - a qualitative study using small-group and individual interviews.

BACKGROUND: As the global population ages, the demand for palliative care is expected to increase. However, studies show that older patients often receive inadequate palliative care, partly due to healthcare professionals lacking sufficient training and tools to identify and address palliative care needs effectively. This study aims to explore healthcare professionals' experiences regarding facilitators and barriers to integrating a palliative care approach in a geriatric setting by implementing the Swedish Palliative Care Guide. METHODS: This qualitative study employed a design consisting of four small-group interviews (with three participants each) and one individual interview, involving a total of 13 healthcare professionals working in a geriatric setting. The aim was to explore their experiences with integrating the Swedish Palliative Care Guide. Data were analyzed using the rapid identification of themes method and inductive content analysis. RESULTS: The analysis revealed four interrelated themes-organizational prerequisites, knowledge of palliative care, teamwork, and communication-that acted as both facilitators and barriers to integrating the Swedish Palliative Care Guide in a geriatric setting. While structured tools and shared goals supported implementation, challenges such as unclear responsibilities, knowledge gaps, and discomfort discussing end-of-life issues hindered consistent application. Participants emphasized that continuity in care and a shared understanding among team members enhanced the use of the guide. In contrast, short-term admissions and a lack of systemic integration of the Swedish Palliative Care Guide into routine practice pose significant challenges to its long-term sustainability. CONCLUSIONS: Successful implementation of the Swedish Palliative Care Guide in geriatric settings requires clear professional responsibilities, integration into existing digital documentation systems, and targeted training to support staff in initiating end-of-life conversations. Tailoring implementation strategies for local conditions, such as short-term admissions and high staff turnover, can enhance sustainability. These findings provide practical guidance for improving the integration of palliative care approaches into everyday geriatric practice.