Between 60-70% of Australians would like to die at home. Only 14% of deaths occur at home. There is no standard approach to out of hospital care for palliative care patients at end of life.

Aim – 

To increase the level of specialised palliative care support to patients at home, enabling people to die in their place of choice.

 

Method –

Calvary Community Palliative Care - Hospital in the Home (PC-HiTH) is admitted care in the patient’s home, as a substitute for in hospital care. It is an opportunity for patients to receive care in their own environment, while offering a model of care that supports patient flow, manages demand, and enables patient choice to enhance their quality of life. Nurse Practitioners are integral to the success of this model, driving sustainability through an expanded scope of practice.

 

Results – 

Whole of service data was reviewed corresponding to the first 6 months of PC-HiTH, and compared with data from those 6 months of the previous year, a total of 77 vs 65 patient deaths. Of these 77 patients 61% were admitted to PC-HiTH. These patients reflected the diversity of this local health district with 13 different countries of birth. 

 

The average number of days on PC-HiTH was 6.7 days. 98% of patients admitted to PC-HiTH died in their place of choice. There were on average double the occasions of service vs non-PC-HiTH in the week prior to death.

The main interventions were End of life care (80%), medications/syringe drivers (76%), pain management (71%), personal care (47%) other symptoms (ranging from 24-34%), education/family support (100%).

Conclusion –

The introduction of PC-HiTH has improved and better supported patients and their carers to manage care at home and dying in their preferred place.