Most Australian palliative care patients prefer to be cared for at home and the majority want to die at home, though less than 10 percent achieve that wish.

caring@home – a national project led by the Brisbane South Palliative Care Collaborative, Metro South Health and funded by the Australian Government – aims to improve the quality of palliative care service delivery across Australia by providing resources that will support people to be cared for and to die at home, if that is their choice.

caring@home has released a range of best practice and consistent resources for community service providers, health care professionals and carers to support carers to help manage breakthrough symptoms safely in community-based palliative care patients using subcutaneous medicines.

These resources include:

  • state and territory specific Guidelines for the handling of palliative care medicines in community services developed by NPS MedicineWise
  • consensus-based list of medicines suitable for use in the community for managing terminal symptoms and endorsed by the Australian and New Zealand Society of Palliative Medicine
  • education resources for carers
  • online education modules for health professionals
  • palliMEDS – a mobile application for prescribers
  • example policy and procedures that can be used by community service providers to develop and/or review relevant documentation within their own policies and procedures framework.

Metro South Palliative Care Service Deputy Director and caring@home Project Director Professor Liz Reymond said that the resources are intended for health care professionals to support carers and palliative care patients living in the community.

“The caring@home package is designed to support nurses to teach carers to help manage breakthrough symptoms safely using subcutaneous medicines prescribed by the person’s doctor/nurse practitioner. If carers volunteer for this role, palliative patients can remain at home for longer,” Professor Reymond said.

One of the most frequent reasons that palliative patients have to be transferred to inpatient units is because their symptoms cannot be adequately controlled at home.

“Apart from unwanted admissions and associated unnecessary health care costs, failure to achieve timely and effective control of symptoms has enormous consequences resulting in tremendous distress to patients, carers and community service providers alike,” Professor Reymond said.

Metro South Palliative Care Service Director Dr Greg Parker said research has shown that carers who are supported with education and resources, tailored to their needs, can confidently, safely and competently manage subcutaneous medicines to relieve breakthrough symptoms in home-based palliative care patients.

“The caring@home resources enable the primary care team to deliver this support to carers,” Dr Parker said.

Carers have reported a great deal of satisfaction from contributing to their loved one’s symptom control and that it impacts positively on their bereavement. Conversely, they report feeling disempowered when unable to provide adequate symptom management.

In early 2019, parts of the carers’ package will be available in Cantonese, Mandarin, Italian, Arabic and Greek.

The resources are applicable in all jurisdictions across Australia and can be accessed and ordered from the caring@home website.

For more information, contact caringathome@health.qld.gov.au or phone 1300 600 007.

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