Dr Karen Cooper1, Prof Liz Reymond1, Mrs Sue Healy2, Mrs Louise Goodwin1
1Brisbane South Palliative Care Collaborative, Eight Mile Plains, Australia,
2Metro South Palliative Care Service, Eight Mile Plains, Australia
For the over seven million people who live outside of major cities in Australia, access to appropriate end-of-life and palliative care can be challenging. And while most Australian palliative care patients say they prefer to be cared for at home, and to die at home if possible, most do not achieve that wish.
Many people, in the terminal stage, are admitted to in-patient facilities because their symptoms cannot be adequately controlled at home. Often, towards the end of life, breakthrough symptoms need to be managed using subcutaneous medicines. Medicine for breakthrough symptoms needs to be given quickly and in rural and remote areas healthcare professionals may not be able to do that given resourcing and distances.
Carers, when appropriately educated, are competent, can safely manage breakthrough symptoms using subcutaneous medicines and that in bereavement they reflect that they are pleased they assumed the role of quasi-professional carer.
caring@home, an Australian Government-funded project, has produced free resources for organisations, healthcare professionals and carers to support carers to help manage breakthrough palliative symptoms safely using subcutaneous medicines.
caring@home resources, applicable to all jurisdictions in Australia, include:
- Guidelines for the handling of palliative care medicines in community services developed by NPS MedicineWise
- A template example policy and procedure for organisations to tailor and guide the operational implementation of the resources
- The palliMEDS app for prescribers
- Online education modules for nurses concerning training of carers
- A comprehensive caring@home package for carers that contains step-by-step guides, a diary, training videos, a practice demonstration kit and a colour-coded labelling system.
caring@home resources are evidence-based and enable service providers in rural and remote areas to implement best-practice care that is person-centred and enables quality end-of-life outcomes for individuals at home and their carers.
Prof Liz Reymond MBBS(Hons), PhD, FRACGP, FAChPM
Prof Reymond is Deputy Director, Metro South Palliative Care Service and Director, Brisbane South Palliative Care Collaborative. Her research interests include palliative care symptom management, advance care planning (ACP), and service delivery and development. Liz is currently directing the Queensland-wide Office of ACP, the Improving End-of-Life Care for Residential Aged Care Facility Residents Initiative (in collaboration with Brisbane South PHN), and the national caring@home project to improve the quality of palliative care service delivery across Australia to support people to be cared for and to die at home, if that is their choice.