Presented by: Caroline Short
A Health Promoting Palliative Care philosophy was embraced to develop medication safety in the palliative care home setting in response to the widespread informal practice of caregivers administering subcutaneous medications, especially in the last few days of life, in a rural palliative care service, New South Wales Australia.
This presentation reports the qualitative research results regarding the expanded role of caregivers in administering medications, managing symptoms and the death in the home setting.
Face to face interviews were conducted to investigate the lived experience of caregivers who participated in the program ‘Improving Medication Safety in the Rural Palliative Care Home Setting.’ The palliative care team claims that this program provides a safe, legal and ethical framework supporting caregivers in the home setting. Initially, concerns regarding this program were identified, broadly discussed and strongly debated with the most notable concern being for caregiver administration of medications at the end of life with subsequent impact on the well-being of caregivers.
The research was conducted to improve understanding of caregiver needs and challenges; caregiver capacity and wellbeing; impact on bereavement; and the possibility of an emerging culture around care of the dying and death in the community.
In consideration that the medication safety program was designed for use in rural areas, enabling a home death for those who prefer the home setting, the results of this study contains some surprising outcomes for those on each side of the debate and potentially could contribute to future palliative care model development across Australia, and beyond.