Integrating specialist palliative care delivery in nursing homes: A scoping review.

The nursing home population is expanding and presenting with increasing medical complexity. Specialist palliative care services collaborate with nursing homes to enhance quality of life for residents with advanced disease through timely identification and provision of palliative care. However, these efforts are often limited by workforce shortages, resource constraints, and a lack of clarity on how specialist palliative care can be effectively integrated into nursing home practice. To identify and map integrated models of specialist palliative care in nursing homes, describe their core components, and summarise reported evaluation outcomes. A scoping review guided by Arksey and O'Malley's framework was conducted. Six databases (PubMed, Web of Science, Scopus, CINAHL, and Cochrane CENTRAL) were searched from inception to end October 2025. Studies describing SPC delivery integrated with routine nursing home care were included. Twenty-three studies were included. Two integrated models were identified: (1) Specialist Consultation Services and (2) Palliative Case Management. Both involved interdisciplinary SPC teams supporting nursing home staff through shared expertise, staff training, and quality improvement initiatives. Specialist Consultation Services provided on-demand, resident-specific consultations, while Palliative Case Management adopted a proactive, team-based approach incorporating case conferences, and palliative care rounds to address residents' ongoing needs. Two complementary models of integrated specialist palliative care in nursing homes were identified. Findings highlight shared and unique components that can inform development of modular, context-appropriate palliative care models tailored to nursing home capacities and resources.