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HCAs make a 'vital contribution' to community palliative care

  • 3 Comments

Employing healthcare assistants under the supervision of district nurses supports end of life care at home, Sheffield researchers have said.

They interviewed 23 patients, carers and nurses, and concluded HCAs could make a “vital contribution” in supporting the provision of end of life care in the community.

The authors said: “Carers welcomed the way assistants developed relationships and became familiar and able to meet the care needs of patients. There were some problems reported which related to capacity, work flow and the need for extensive written care plans.”

  • 3 Comments

Readers' comments (3)

  • i think that HCA's make a vital contribution in all aspects of nursing - they are often the unsung heroes of nursing, yet they provide alot of the groundwork. They are able to develop relationships and become familiar with their patients as they are not bogged down with paperwork ... keep up the good work all HCAs out there !!!

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  • The authors said: “Carers welcomed the way assistants developed relationships and became familiar and able to meet the care needs of patients. There were some problems reported which related to capacity, work flow and the need for extensive written care plans.”

    I have been at the amateur end of 'EoLC palliative care at home' and anybody who is there, should be making a useful contribution - 'dying' is not some sort of spectator sport !

    I have a lot of problems with 'the emphasis on written detailed care plans' and would much prefer the stress to be on everyone involved, talking openly to each other, so that everyone - patient, relatives and family, etc - who is 'closely involved with the patient', properly understands what is going on, and what should happen in the future, and what the best course of action in any given situation is likely to be. And for people to remember, that the patient is the person who makes his own decisions, not the clinicians.
    This introduces a fundamental separation, in essence between those people who '(could) talk to the patient a lot' and those who don't - currently the separation appears to be between clinicians and amateurs, which is unsound for home care.

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  • @ Anonymous | 27-Jun-2011 9:42 am

    you might take some comfort from the nhs end of life care programme's section on assessment and care planning: "early assessment of an individual’s needs and wishes as they approach the end of life is vital to establish their preferences and choices and identify any areas of unmet need. It is important to explore the physical, psychological, social, spiritual, cultural and, where appropriate, environmental needs / wishes of each individual."

    http://www.endoflifecareforadults.nhs.uk/

    however, i've witnessed the outcome of poor care planning, agency carers continuing to administer all of the medications that the service user had been prescribed before their last hospital admission and subsequent rapid discharge to end life at home. far too great a pharmaceutical burden, including liquid oral medications which, in view of a poor gag reflex, were totally inappropriate.

    good care planning, even the rapid discharge pathway, can make the difference a peaceful passing or a traumatic ending.

    the care pathways and training are available to any trust that, even in times of financial constraint, considers this an area of high priority. but as things stand, too many hca's, nurses, care managers, etc. lack the appropriate training, do not know who their counterpart eol specialists in different services are, etc.

    providers need to make commissioners aware of the need for eol funding. especially as the vast majority of people in this country want to end their lives at home, with caring professionals who are confident in what they're doing, and if really lucky, with loving family around them.

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