Improving choices for community palliative care: a prospective 2-year pilot of a live-in support person

摘要

Introduction: This prospective pilot evaluates a free-to-client, live-in support person (LISP) for community palliative care. People who needed additional support to be at home rather than in hospital/hospice were included. A LISP from 0900 Monday to 1600 Friday was offered to palliative clients for an initial 2-week placement.Patients and Methods: Over 24 months, a sequential cohort was evaluated. Hospital admissions avoided and discharges facilitated, costs and potential uptake rates were gathered. Caregivers provided feedback 3 months after the placement.Results: The LISP had 49 long-term placements with 44 clients saving 409 bed days. Median placement was short (5 days; range, 2–33 days). Only 8 clients used the LISP around-the-clock. Net potential savings (allowing for caregiver costs) were AU$11,379 annually. Qualitatively, caregivers appreciated the re-assurance offered.Discussion: This pilot study supports the need for a randomised controlled trial to evaluate further the role of the free-to-client, LISP for community palliative care. Evaluating new models of service delivery for patients and caregivers is imperative in palliative care. The LISP improves choices for people in a cost-neutral way if existing services can be substituted.