Home-based Care Model Research Articles

Home-based postnatal midwifery care facilitated a smooth succession into motherhood: A Swedish interview study.

If a family is discharged from a hospital earlier after birth, close supervision by a skilled midwife is essential. The aim was to describe mothers' overall experience receiving postnatal care in a Swedish home-based midwifery care model. A descriptive qualitative study was conducted. Mothers meeting the inclusion criteria for a new home-based postnatal care model at a hospital in Stockholm, Sweden, were included. In total, 24 healthy mothers participated in a semi-structured telephone interview, averaging 58 minutes. Data were analyzed using thematic analysis, according to Braun and Clarke. The main theme explored, 'The home-based postnatal care model facilitated a smooth succession into motherhood', is explained by the themes: 1) Mothers felt 'not left adrift' when cared for by the home-based postnatal midwives; 2) Professional midwives with authority guided the way into motherhood; and 3) The home, a safe and secure space for new mothers. Mothers valued the well-structured home-based postnatal midwifery care. Important for mothers was to receive health checks, adequate information, and that midwives have a kind and individual approach to the families. Midwives play an important role for mothers in the early days after the birth of their baby.

“But at home, with the midwife, you are a person”: experiences and impact of a new early postpartum home-based midwifery care model in the view of women in vulnerable family situations

BackgroundPostpartum home-based midwifery care is covered by basic health insurance in Switzerland for all families with newborns but must be self-organized. To ensure access for all, Familystart, a network of self-employed midwives, launched a new care model in 2012 by ensuring the transition from hospital to home through cooperation with maternity hospitals in the Basel area. It has particularly improved the access to follow-up care for families in vulnerable situations needing support beyond basic services. In 2018, the SORGSAM (Support at the Start of Life) project was initiated by Familystart to enhance parental resources for better postpartum health outcomes for mothers and children through offering improved assistance to psychosocially and economically disadvantaged families. First, midwives have access to first-line telephone support to discuss challenging situations and required actions. Second, the SORGSAM hardship fund provides financial compensation to midwives for services not covered by basic health insurance. Third, women receive financial emergency support from the hardship fund.AimThe aim was to explore how women living in vulnerable family situations experienced the new early postpartum home-based midwifery care model provided in the context of the SORGSAM project, and how they experienced its impact.MethodsFindings are reported from the qualitative part of the mixed-methods evaluation of the SORGSAM project. They are based on the results of seven semi-structured interviews with women who, due to a vulnerable family postpartum situation at home, received the SORGSAM support. Data were analyzed following thematic analysis.ResultsInterviewed women experienced the early postpartum care at home, as “relieving and strengthening” in that midwives coordinated patient care that opened up access to appropriate community-based support services. The mothers expressed that they felt a reduction in stress, an increase in resilience, enhanced mothering skills, and greater parental resources. These were attributed to familiar and trusting relationships with their midwives where participants acknowledged deep gratitude.ConclusionThe findings show the high acceptance of the new early postpartum midwifery care model. These indicate how such a care model can improve the well-being of women in vulnerable family situations and may prevent early chronic stress in children.

Research on home care model of intelligent community based on SD model -- Taking Meilin community as an example

The problem of aging has appeared in some countries, and the problem of providing for the aged has become one of the key issues. In recent years, aging has also become a social problem in China, but the current pension model can not meet the diversified and personalized needs of the elderly in China. In this paper, the intelligent community home-based elderly care model has become the forefront of academic research and a new topic of elderly care practice. On this basis, this paper sorts out the research context of the home-based elderly care model in smart communities, and uses Maslow's Hierarchical Needs Theory (MHNT) and Welfare Pluralism Theory (WPT) as research methods to analyze the needs of the elderly and the choice of welfare providers. In addition, this paper uses the method of system dynamics to establish a model to analyze the supply and demand balance of different pension models, and demonstrates the advancement of community home-based pension model. Finally, through the interview and investigation of the staff and managers of the smart community home-based elderly care model in Meilin community, Dongzhi County, Anhui Province, China, this paper summarizes the existing elderly care model in the community, and finds some deficiencies, such as the lack of full-time personnel, the inadequate use of new technologies and the lack of financial support. According to this, the paper puts forward corresponding countermeasures: (1) the problems of personnel can be solved by strengthening the training of service personnel, improving the system of volunteers and community service personnel working together, etc;(2) The problem of technology application can be solved by cooperating with external enterprises or other organizational units in research and development; (3In terms of financial support, it is necessary to broaden the channels of obtaining funds, seek the cooperation of enterprises, and adopt the innovative pension service mode of charging for providing high-end services and using the income for public welfare free basic services to effectively raise funds. Through the above research, the authors can put forward solutions to the pension problems faced by Meilin community, integrate relevant resources, and reduce the social burden.

Pension level, subjective wellbeing, and preference of care model among elderly people: An empirical study based on structural equation modeling.

The problem of population aging is becoming increasingly serious, and the elderly care model has become the social focus in China. It is urgent to improve the traditional home based elderly care model and increase the recognition of the residents for the socialized elderly care model. Based on the data of the 2018 China Longitudinal Aging Social Survey (CLASS), this paper uses structural equation model (SEM) to empirically test the impact of the elderly group's social pension level and subjective well-being on their choice of various care models. The results show that the improvement of elderly's pension level can significantly inhibit their choice of home-based care model, and promote their choice of community and institution care model. Subjective well-being can play a mediating role in the home-based and community care model choices, but the indirect approach mediated by subjective well-being only plays a supplementary role. In addition, the heterogeneity analysis shows that there are discrepancies in the impact and path for the elderly with different gender, age, household registration, marital status, health status, education level, number of children, and gender of children. The results of this study will help the improvement and development of social pension policy, optimizing the structure of residents' elderly care model and the process of "active aging".

"We are the sun for our community:" Partnering with community health workers/promotores to adapt, deliver and evaluate a home-based collaborative care model to improve equity in access to quality depression care for older U.S. Latino adults who are underserved.

While depression is a leading cause of poor health, less than half of older adults receive adequate care. Inequities in both access and outcomes are even more pronounced for socially disadvantaged older adults. The collaborative care model (CCM) has potential to reduce this burden through community-based organizations (CBOs) who serve these populations. However, CCM has been understudied in diverse cultural and resource-constrained contexts. We evaluated the implementation and effectiveness of PEARLS, a home-based CCM adapted with and for community health workers/promotores (CHWs/Ps). We used an instrumental case study design. Our case definition is a community-academic partnership to build CHW/P capacity for evidence-based depression care for older U.S. Latino adults in the Inland Empire region of California (2017-2020). We aimed to understand adaptations to fit local context; acceptability, feasibility, and fidelity; clinical effectiveness; and contextual determinants of implementation success or failure. Data sources included quantitative and qualitative administrative and evaluation data from participants and providers. We used descriptive statistics and paired t-tests to characterize care delivery and evaluate effectiveness post-intervention, and deductive thematic analysis to answer other aims. This case study included 152 PEARLS participants and nine data sources (N = 67 documents). The CBO including their CHWs/Ps partnered with the external implementation team made adaptations to PEARLS content, context, and implementation strategies to support CHWs/Ps and older adults. PEARLS was acceptable, feasible and delivered with fidelity. Participants showed significant reductions in depression severity at 5 months (98% clinical response rate [mean (SD), 13.7 (3.9) drop in pre/post PHQ-9; p < 0.001] and received support for 2.6 social needs on average. PEARLS delivery was facilitated by its relative advantage, adaptability, and trialability; the team's collective efficacy, buy-in, alignment with organization mission, and ongoing reflection and evaluation during implementation. Delivery was challenged by weak partnerships with clinics for participant referral, engagement, reimbursement, and sustainability post-grant funding. This case study used existing data to learn how home-based CCM was adapted by and for CHWs/Ps to reduce health inequities in late-life depression and depression care among older Latino immigrants. The CBOs and CHWs/Ps strong trust and rapport, addressing social and health needs alongside depression care, and regular internal and external coaching and consultation, appeared to drive successful implementation and effectiveness.

How to promote the healthy development of continuous participation in smart medical and elderly care systems: The dual perspective of perceived value and risk.

In an environment with an ageing population, elderly care has become a focus of social attention. The combination of smart medical care with elderly care and how to encourage the elderly to participate in the systems and enjoy a higher quality of life have become social priorities. We aimed to analyse the perceived risk and value associations of self-health management-conscious older adults regarding smart medical and elderly care systems (SMECS) and to explore the mechanisms of SMECS affecting them. Using a Likert scale, we conducted a questionnaire-based survey and collected 387 valid responses. This was a cross-sectional study, and various key data were collected relating to the continued participation of older users in SMECS. Partial least squares structural equation modelling was used to explore the data. According to the data analysis, price, operability and personalisation all have significant correlations with perceived value and perceived risk. Perceptions of value and risk influence the continuous participation of the elderly, and this has a potentially positive effect on their mental and physical health. Under the home-based care model, economic factors and technological accessibility were important factors affecting the elderly's continuous participation in SMECS. A personalised programme for the elderly warrants attention. In addition, the effect of perceived risk from the health-related systems was stronger than their perceived value. This research can help elderly users bridge the digital divide and enjoy smart health and medical care.

Home-based health care model for caring of family in the prevention of COVID-19

Home-based health care model for caring of family in the prevention of COVID-19

BRINGING HOME CARE TO HUD HOUSING: AN EVALUATION OF NEW JERSEY'S ASSISTED LIVING PROGRAM

Abstract The Assisted Living Program (ALP) in New Jersey provides home care services, financed by Medicaid and self-pay, to older adults living in low-income HUD housing. Because the program had attracted few providers and had low uptake, we designed a qualitative study aimed at understanding experiences of ALP participants compared to non-participants. After pandemic-related postponements, the study began in June 2021, collecting data from 63 respondents. Findings revealed differences in the demographics and needs of older New Jerseyans as well as differences between participants and non-participants in ALP. This paper will review the study and discuss investigators’ conclusions about how to strengthen this highly viable model of home-based care and better serve low-income older adults in New Jersey. Opportunities for improvement include modifications to regulations and financing; marketing of services, and collaboration among ALPs and housing providers.

Home-based primary care in Canada: Five innovative urban practices.

While the home-based primary care model offers potential patient and system-level benefits, implementation of interprofessional home-based primary care teams has not been widespread. When caring for homebound patients, family physicians are often not included as regular contributors or participants in the team that coordinates and plans much of the care for these patients. To describe a selection of home-based primary care practices and to identify barriers to and facilitators of the creation and sustainability of these models within the publicly funded health care system. Five existing home-based primary care practices were examined: 1 each in Victoria and Vancouver in BC; 1 in Winnipeg, Man; and 2 in Toronto, Ont. The research team conducted semistructured team interviews, interviews with the physician leads, and informal observation of elements of team-based care planning at these 5 sites. From these sources, descriptions of each practice were developed in terms of practice history, context, and initiating factors; practice goals and performance management; and practice design elements, including target population, referral sources, and team composition. A qualitative thematic content analysis was used to extract and distil implementation barriers and facilitators across the 5 practices. Members of each practice team validated the interpretation of thematic information. Substantial heterogeneity was found in the composition of the interprofessional teams. The overarching initiating factor for the home-based component of all practices could be described as identifying and addressing unmet community need. Physician leadership, creative funding models, team camaraderie, and community partnerships were the main facilitators. Limited health system support, geography, and lack of existing models of care were the main barriers. Substantial barriers to wider implementation of home-based primary care practices persist. Examination of existing practices identifies the importance of physician leadership and commitment to meeting community need.

Physical environment research of the family ward for a healthy residential environment.

Climate change and population aging are two of the most important global health challenges in this century. A 2020 study by the Environmental Protection Agency showed that average people, particularly older adults, spent 90% of their time at home. This is even more evident during the coronavirus disease 2019 (COVID-19) pandemic. Home-based care models have become a new trend. The health and comfort of the living environment profoundly impacts the wellbeing of older adults. Therefore, research on the physical environment of the family wards has become an inevitable part of promoting the health of older adults; however, current research is still lacking. Based on the study and analysis of continuous monitoring data related to elements of the physical environment (thermal comfort, acoustic quality, lighting quality, and indoor air quality) of family wards, this paper explores the living behaviors of the participants in this environmental research (open or closed windows, air conditioning, artificial lighting, and television) on the indoor physical environment. (1) While referring to the requirements of international standards for an indoor aging-friendly physical environment, we also discuss and analyze the physical environment parameter values according to Chinese standards. (2) People's life behaviors have different degrees of influence on the elements of indoor physical environments. For example, opening doors and windows can alleviate the adverse effects of indoor environmental quality on the human body better than simply turning on the air conditioner. (3) Owing to the decline in physical function, older adults need special care. Studying the status quo of physical environmental elements and proposing suitable environmental improvement measures for aging are of great significance. (4) This research aims to address global warming and severe aging and to contribute to sustainable environmental development.

The Business Case to Care for Persons With Serious Illness Using Home-Based and Community-Based Palliative Care.

The number of persons with serious illness in America has dramatically increased over the last half decade, while the cost for health care quadrupled. The trajectory of these chronic conditions can mean declining health, frequent emergency department visits and more hospitalizations, driving up health care costs, and reducing quality of life. Palliative care, a viable solution to reducing disease burden, improving quality of life, and decreasing costs, has been offered in hospitals for many years and is now a standard of care and practice. Palliative care can be provided while concomitantly offering disease-targeted treatment. Home-based and community-based palliative care models offer new and innovative avenues for the provision of palliative care outside the hospital walls. Definitions to differentiate between palliative care, hospice, and long-term services and support will be presented. How to make the business case for home-based or community-based palliative care will be made, with insights, resources, and tools for calculating the return on investment. The role and competencies for palliative care nurse leaders will be explored.

Acute home-based care for patients with cancer to avoid, substitute, and follow emergency department visits: a conceptual framework using Porter’s Five Forces

BackgroundPatients with cancer constitute a large and increasing segment of patients who receive unscheduled hospital-based care due to treatment-related symptoms and disease progression. The initial hospital-based touchpoint for these unscheduled hospitalizations is often the emergency department. Traditional models of emergency department and inpatient hospital-based care are saturated and incapable of scaling to accommodate the future, increased needs projected for this population. New models of care are necessary to address this gap. Acute home-based care is a promising tool potentially providing patient-centric, efficient care to eligible patients.MethodsWe applied Porter’s Five Forces framework that addresses the bargaining power of buyers and suppliers, threat of substitutes and new entrants, and industry rivalries plus the sixth force of regulation to clarify the factors that will promote or challenge the adoption of a home-based cancer care referral model before or following emergency department visits. Exploring this framework provides insights into the complexities of scaling an acute home-based cancer care model and highlights ways for health systems including hospitals, emergency departments, physician groups, and individual emergency physicians and oncologists to optimize their roles in this emerging model of care.ResultsWe found that current workforce shortages, as well as workflow, infrastructure, and regulatory complexities, pose major challenges that unless carefully addressed may restrict the growth of acute home-based cancer care. Additional uncertainties persist around appropriate payment models and the competitive landscape. Key promoting factors include the recognized need in the cancer community and among payers for new models to decrease unscheduled hospitalizations and emergency department visits as well as the uptake of home-based and technology-enabled solutions during the COVID-19 pandemic. A better understanding of these forces helps to clarify the risks and opportunities as new entrants build their programs.ConclusionsAcute home-based cancer care is a promising tool to complement traditional outpatient clinics, emergency departments, and inpatient hospital-based models of cancer care. New technologies and policies increasingly enable a broader scope of cancer care in the home setting.

Home-Based Care Reimagined: A Full-Fledged Health Care Delivery Ecosystem Without Walls.

The COVID-19 pandemic exposed the dangers of tying health care delivery to brick-and-mortar health care facilities. Both before and, more intensely, during the pandemic, health systems have struggled to support high-need patients, especially those unable to engage with virtual technology or needing urgent care in the home. The pandemic has highlighted an ongoing need to create a distributed health care delivery ecosystem centered in patients' homes and the community. This age-friendly ecosystem would initially focus on high-need patients, expand access, improve equity, and be of high value. It would integrate episodic and longitudinal care and expand to serve broader populations as it matures. We briefly describe the evidence base for home-based care models that constitute this ecosystem, define the guiding principles underlying it, and discuss what will be required to build out and scale it.

Using a Stakeholder Co-Design Framework to Develop a Pediatric Telemedicine Home-Based Palliative Care Model (TH156)

Using a Stakeholder Co-Design Framework to Develop a Pediatric Telemedicine Home-Based Palliative Care Model (TH156)

The Construction of a Community Long-term Care Model for Home-based Elderly Individuals.

With rapidly aging populations, family care functions can become weakened, and community health services often lack unified standards. A standardized and professional community home-based long-term care model (CHLCM) for the elderly is urgently needed in many regions of China and in other countries. Here, we explored the indicators of the need for a CHLCM among elderly individuals, and we constructed a CHLCM. We created and distributed a questionnaire regarding the requirement of long-term care services, based on a literature review. The two-rounds Delphi method was used, involving 20 experts who were randomly selected from among the medical universities, community health service centers, and nursing homes in Nanning, Guangxi, China. The experts' enthusiasm rates in the questionnaire's two rounds were 95% and 100%, respectively. The authentic coefficient of the experts' consulting was 0.857, and that of the experts' academic level was 0.835; the judgement coefficient was 0.880 and the familiar coefficient was 0.855. The CHLCM includes service content and an evaluation. The coordination coefficients for the two primary, eight secondary, and 29 tertiary indicators were 0.200, 0.386, and 0.184, respectively (p<0.05). The experts' enthusiasm and authority were high. The coordination of the experts' agreement was sufficient, and the analysis results were reliable. The CHLCM includes 29 items that provide a foundation and references for the formulation of concrete indicators and subsequent research.

The impact of Covid-19 on malaria services in three high endemic districts in Rwanda: a mixed-method study

BackgroundRwanda has achieved impressive reductions in malaria morbidity and mortality over the past two decades. However, the disruption of essential services due to the current Covid-19 pandemic can lead to a reversal of these gains in malaria control unless targeted, evidence-based interventions are implemented to mitigate the impact of the pandemic. The extent to which malaria services have been disrupted has not been fully characterized. This study was conducted to assess the impact of Covid-19 on malaria services in Rwanda.MethodsA mixed-methods study was conducted in three purposively selected districts in Rwanda. The quantitative data included malaria aggregated data reported at the health facility level and the community level. The data included the number of malaria tests, uncomplicated malaria cases, severe malaria cases, and malaria deaths. The qualitative data were collected using focus group discussions with community members and community health workers, as well as in-depth interviews with health care providers and staff working in the malaria programme. Interrupted time series analysis was conducted to compare changes in malaria presentations between the pre-Covid-19 period (January 2019 to February 2020) and Covid-19 period (from March 2020 to November 2020). The constant comparative method was used in qualitative thematic analysis.ResultsCompared to the pre-Covid-19 period, there was a monthly reduction in patients tested in health facilities of 4.32 per 1000 population and a monthly increase in patients tested in the community of 2.38 per 1000 population during the Covid-19 period. There was no change in the overall presentation rate for uncomplicated malaria. The was a monthly reduction in the proportion of severe malaria of 5.47 per 100,000 malaria cases. Additionally, although healthcare providers continued to provide malaria services, they were fearful that this would expose them and their families to Covid-19. Covid-19 mitigation measures limited the availability of transportation options for the community to seek care in health facilities and delayed the implementation of some key malaria interventions. The focus on Covid-19-related communication also reduced the amount of health information for other diseases provided to community members.ConclusionThe Covid-19 pandemic resulted in patients increasingly seeking care in the community and poses challenges to maintaining delivery of malaria services in Rwanda. Interventions to mitigate these challenges should focus on strengthening programming for the community and home-based care models and integrating malaria messages into Covid-19-related communication. Additionally, implementation of the interrupted interventions should be timed and overlap with the malaria transmission season to mitigate Covid-19 consequences on malaria.

Effects of a transitional home-based care program for stroke survivors in Harbin, China: a randomized controlled trial.

China has the biggest stroke burden in the world. Continued measures have been taken to enhance post-stroke rehabilitation management in the last two decades. The weak link is with home-based rehabilitation, with more attention and resources devoted to inpatient rehabilitation. to address the service gap, this study tested a home-based transitional care model for stroke survivors. a randomized controlled trial was conducted from February 2019 to May 2020 in Harbin, China, involving 116 patients with ischemic stroke. The intervention group participants (n = 58, 50%) received a 12-week home-based care program with components of transitional care measures and the national guidelines for facilitating patients to perform home-based exercises with continued monitoring and gradual progression. Control group participants received standard care including medication advice, rehabilitation exercise and one nurse-initiated follow-up call. Data were collected at baseline and after a 90-day (post-intervention) and a 180-day (post-intervention) follow-up. The primary outcome was quality of life (QOL), measured using the EuroQol-Five Dimension 5-Level scale (EQ-5D-5L). both intervention and control groups showed improvement in EQ-5D-5L from baseline to post-intervention (0.66 versus 0.83, P < 0.001) and (0.66 versus 0.77, P < 0.001), respectively, and there was significant group-by-time interaction in EuroQol-Visual Analogue Scale from baseline to post-intervention at 90days and follow-up at 180days with the intervention group experiencing better improvement. Similarly, significant interaction effects were also found in the Stroke Impact Symptom scale, self-efficacy and modified Barthel Index. home-based transitional care was effective in improving QOL, symptoms, self-efficacy and activities of daily living.

China’s “Embedded Neoliberal” Home-Based Elderly Care? A State-Organised System of Neighbourhood Governance

Embedding the program of elderly care into community-based service system seems to imply that China is reorganising capacities of neighbourhood governance. The program, created by transformation of neighbourhood governance, represented the state government’s frustration with the institutional embodiment of neoliberalism. However, stimulating neighbourhood organisations in elderly care service through involvement of market instruments demonstrated the neoliberal approach. In this study, we provided a research framework in the context of embedded neoliberalism to explore the dilemma of neighbourhood governance in China. By interviewing 100 elderly people in five neighbourhoods in Nanjing, China, we examined the home-based elderly care (HEC) model to analyse the changes in socio-spatial relationships of neighbourhoods. We argued that the state-organised system of market instruments as a form of neighbourhood system weaken the spontaneity of elderly residents in developing social capitals. Moreover, the emerging program is struggling to operate because the devolution of conservative governance capacity from the state to the neighbourhood does not provide resources, leading to the restrained market provision. Thus, this transformation of neighbourhood governance can only be effective if there is a clear complementarity relationship between the role of state and market instruments. The attention of further studies on neighbourhood governance needs to re-examine the reciprocal relationships in the context of declining neoliberalism.

Family life starts at home: Fathers’ experiences of a newly implemented Swedish home-based postnatal care model – an interview study

ObjectiveTo explore and describe fathers’ experiences of a newly implemented Swedish home-based postnatal care model. DesignA descriptive cross-sectional qualitative study was conducted as a part of a larger study. SettingFamilies who qualified to be discharged early were offered to participate in a postnatal home-based model of midwifery care by a hospital in Stockholm, Sweden. Participants and MeasurementsIn total, 16 fathers participated in a semi-structured telephone interview, averaging 43 min. Data were analyzed using systematic text condensation. FindingsThree major themes emerged: To decide on home- or hospital-based postnatal care – a matter of safety, To be offered professional midwifery postnatal support at home, and To be at home helped fathers to navigate parenthood. Fathers appreciated the home-based postnatal care and felt safe because of the received professional support from midwives. Key conclusionsHome-based postnatal care was valued by fathers whose partner had a non-complicated vaginal birth because they felt safe in their home environment and supported by midwives. The home environment aided fathers in supporting their partners and developing a father-infant bond. Implications for practiceHome-based postnatal care was valued by fathers and should be considered an option for new families. To offer home-based postnatal care may result in less overcrowded postnatal wards. Midwives need to enable fathers’ participation and support their parental role regardless of where the care takes place.

Development of a model of Home-based Cancer Palliative Care Services in Mumbai - Analysis of Real-world Research Data over 5 Years.

Patients needing palliative care prefer to be cared for in the comfort of their homes. Although private home health-care services are entering the health-care ecosystem in India, for the majority it is still institution-based. Here, we describe a model of home-based palliative care developed by the Tata Memorial Hospital, a government tertiary care cancer hospital. Data on patient demographics, services provided and outcomes were collected prospectively for patients for the year November 2013 - October 2019. In the 1st year, local general physicians were trained in palliative care principles, bereavement services and out of hours telephone support were provided. In the 2nd year, data from 1st year were analysed and discussed among the study investigators to introduce changes. In the 3rd year, the updated patient assessment forms were implemented in practice. In the 4th year, the symptom management protocol was implemented. In the 5th and 6th year, updated process of patient assessment data and symptom management protocol was implemented as a complete model of care. During the 6 years, 250 patients were recruited, all suffering from advanced cancer. Home care led to good symptom control, improvement of quality of life for patients and increased satisfaction of caregivers during the care process and into bereavement. A home-based model of care spared patients from unnecessary hospital visits and was successful in providing client centred care. A multidisciplinary team composition allowed for holistic care and can serve as a model for building palliative care capacity in low- and middle-income countries.