Organisation: Barwon Health

Background/objective: The COVID-19 pandemic has brought the use of telehealth to the fore, as many people have been unable to interact directly with healthcare professionals (HCP). For community palliative care (CPC) services, this has meant a sudden change from a predominantly face-to-face model of care to one that incorporates telehealth. Understanding patient and HCP experiences with telehealth and how telehealth compares to ‘usual’ care will be crucial in planning future CPC services.

Methodology: All patients of the Barwon Health CPC service between 1 April and 31 May 2020 were invited to complete a questionnaire evaluating their interactions with the palliative care service and specifically their involvement with telehealth consultations. Palliative care HCP who provided clinical services during the same time period were also surveyed.

Results/conclusion: Seventy-four patients (response rate 36%) and 22 HCP returned surveys. Both groups felt comfortable using telehealth, however, also encountered a range of issues when undertaking telehealth consultations. Despite reporting issues, the preference of both groups was for a CPC service model, which combined face-to-face and telehealth consultations. This study is one of the first to directly ask this question and as such provides useful guidance for health services when planning future CPC service models.

Associate Investigators: Anna Dowd, Jacqui White, Matthew Ely, Jill Carter

Background: According to the Grattan Institute in 2014, 70% of Australians indicated a preference to die at home, however, only 14% of all deaths were at home.

Aims: To identify how patients can be supported to die at home if that is their preference.

Methods: A retrospective medical record audit of eligible Community Palliative Care (CPC) patients who indicated a wish to die at home was undertaken.

Findings: Out of a total of 114 patients, 74% indicated a preference to die at home. Of these, 66% achieved a home death, and most lived with a carer. Enablers for home death included family support, regular nursing visits and equipment. People who attended an emergency department in their last month of life, lived alone or were undergoing oncological treatment were more likely to die elsewhere.

Conclusion: A range of enablers and barriers to home death were found, with many of the enablers being factors that prevented hospital presentations

Citation: Int J Palliat Nurs. 2023 Jul 2;29(7):326-333. doi: 10.12968/ijpn.2023.29.7.326

Authors: Anna Dowd, Melanie Davies, Sarah Short, Ruth Morrison, Cheryl Spiller, Jill Carter, Peter Eastman