Research indicates that if a patient receives the necessary levels of support in the last twelve months of their life, it will result in a significant impact on their quality of life and that of their family. Access to community-based home care services provides palliative care patients with the care and support to remain at home for as long as possible. The process to access can be time consuming, stressful, and funding is not routinely provided to those people who are palliative and under the age of 65. WA Country Health Services (WACHS) Palliative Care Program uses specific clinical criteria to assess for eligibility to access a Palliative Care Support Package (PCSP), for patients and carers/family. PCSPs can assist palliative care patients who do not qualify for, or do not have time to wait for, approvals from the National Disability Insurance Scheme (NDIS), the Commonwealth Home Support Programme (CHSP) or Home Care Packages (HCP’s).

Aim

The PCSP aims to provide holistic home care support within a responsive time frame and meet induvial needs. The program provides funding for up to six weeks. 

Services provided are:
·       Personal care
·       Social support
·       Respite care
·       Nursing care

The funding is for people who are approaching end of life and meet the following eligibility criteria:
·       Under the WACHS Specialist Regional Palliative Care Service
·       Too late to progress a timely application for a NDIS, CHSP and HCP package due to rapid deterioration
·       Children receiving palliative care
·       At risk of hospital or residential aged care admission due to no access to home care services
·       Waiting for a NDIS access decision, Ability First Access, or HCPs to commence.

Results

The packages commenced in February 2020 with over 270 PCSPs approved to date. The use of Palliative Care Outcomes Collaboration (PCOC) assessment tools ensures a multidisciplinary approach to measuring clinical care needs. Partnering with 14 community services has provided an effective use of the work force in seven regional areas. The average cost of the PCSPs delivered is $1820. Case studies analysis has demonstrated significant cost savings on reducing emergency department admissions and long hospital stays for palliative care patients substituted with receiving care and support at home. Data suggests that of the patients accessing PCSP; 80% have a carer, 61% are male and ages ranging from 5 to 93 years. The main presenting symptom is fatigue (41%), and 45% of patients are in a deteriorating phase.

Conclusion

The packages are innovative in rural Western Australia to assist with end-of-life care in the home and have demonstrated assistance with providing care in a responsive timeframe, reducing hospitalisations by providing the support the patient/carer needs in their own home. Future developments will be the creation of culturally appropriate Aboriginal Palliative Care Support Package and care delivery in remote towns.