A10-C A Palliative Care Home Support Program in New South Wales (NSW), Australia – Design and Evaluation

Abstract

To ascertain whether a program providing specially trained Community Care Workers (CCWs) is effective in supporting palliative care patients and their families with end-of-life care in the home. The program was delivered in 7 Local Health Districts (LHDs) across metropolitan and regional NSW. A training workshop was developed and delivered to CCWs, and evaluated using post-workshop evaluation questionnaires. Family carers who received CCW support were invited to provide an anonymous evaluation survey on their experience with the program, approximately 3 months after their loved one had died. A purposive sample of CCWs, family carers and clinical staff from Specialist Community Palliative Care Teams (SCPCT) from each LHD were also invited to participate in qualitative telephone interviews about the program. Over 300 patients received this service during the evaluation period. CCWs indicated that the training enhanced their skills, knowledge and confidence in supporting palliative care patients and their families. Most family carers had no previous experience in providing this type of care. Moreover, many had limited networks of support, and some had their own health issues. Over 80% of respondents were happy with their decision to support their loved one to die at home. They reported that CCWs assisted with personal patient care, overnight respite care, advice on patient care, and emotional support. Interviews with SCPCT members suggest that the program was more easily implemented in metropolitan areas. In regional LHDs the challenges were geographical distances, a shortage of skilled staff, and carer reticence to having ‘strangers’ come into their homes. SCPCT members reported that palliative care-trained CCWs were able to effectively support carers. Challenges external to the program were identified in some Districts. These included limited access to palliative care specialists and general practitioner home visits. CCWs were effective in supporting patients and carers with end-of-life care in the home.