Publication
Optimising wellbeing and empowering people to live independently with advancing illness
From Department of Health
Published on
Last updated on
From Department of Health
Published on
Last updated on
Rehabilitative Palliative Care, a new Sláintecare pilot service run between St Francis Hospice and the Mater Hospital is providing integrated care that integrates the hospital and community elements of palliative care. The service aims to create a positive impact on patients’ lives, optimising their quality of life, and reduce their length of stay in hospital.
This service provides an opportunity for patients who are in the general hospital environment to be discharged in to the community with the support of Occupational Therapy in the Mater Hospital and Physiotherapy in the community, allowing them to live well at home.
The community-based specialist palliative care physiotherapist can visit patients at home, ensuring that patients can receive services even if they are too unwell to leave their own home.
The service has treated over 250 patients to date, and has allowed patients with life-limiting conditions to self-manage their condition, and to enjoy their best quality of life at home.
Patients are very appreciative of the improved mobility and independence the service has allowed them: >“Even to walk 20 or 30 metres was a problem…I never knew whether I was going to stumble or not and I wanted to be able to do that …I like to go and get my paper every morning. …as time has gone by, all that is no longer an issue, I can get by and get over that quite easily”
Another patient commented:
“It’s just a feeling of freedom, even though it’s a very short bit of freedom…it’s the feeling that I’m not totally confined to the four walls”
The services focuses on the whole journey of the patient and the integration of services between hospital and community. The service has put a streamlined system in place, where patients are linked in to either occupational therapy or physiotherapy, or both. Protecting patient time is very important to the clinicians and therapists involved in this service, who prioritise granting patients quick access to informed care at home following hospital discharge.
Patients responded very positively to this streamlined approach:
“They all knew what was happening, so obviously the case is discussed…all knew what was going on, what needed to be done, what was being done…so you had great confidence with that.”
Caregivers reported feeling supported to continue caring for their loved one with specialist assistance at home:
“He’s improved not only in his own physical thing but his own mental ability, because he had kind of given up and we were thinking ‘ what are we going to do?.... now, he jumps up to show her what he can, now that he can walk that bit better and walk further.”
Patients and families have benefitted from a new focus on rehabilitative palliative care delivered in the 'right place' at the 'right time'.
Early review in the hospital setting means that patients' symptoms are controlled more quickly, functional ability is improved as far as is possible, and discharge planning is managed in a timely and more efficient manner.
Communication and integration of services has been improved and the 'silos' of hospital and community broken down by virtue of working across boundaries and transitions of care.
A case study analysis is currently in process but preliminary findings are that patients benefit as they feel empowered, have greater confidence and ability to self-manage symptoms and have improved quality of life. The quality of discharge from hospital is improved because of better communication and care planning.
The Department of Health plans to update the Palliative Care Policy for Adults in 2022 and has recently launched a public consultation to allow the general public to have their say. The public consultation consists of an online survey which can be accessed here. The survey seeks to understand the public’s awareness of palliative care and captures their views on current services as well as future priorities for the policy update. The survey is anonymous and takes 5 minutes to complete. It will remain open until Monday 25th October. The survey will provide valuable information about the views of the nation on how care for people with a serious and progressive illness is delivered in Ireland and help to shape the development of palliative care services here in the future.