Specialized palliative care services are associated with improved short- and long-term caregiver outcomes

Abstract

Goals of work The goal of this study was to evaluate, at a population level, the association between specialized palliative care services (SPCS) and short- and long-term caregiver outcomes. Patients and methods The Health Omnibus Survey, a face-to-face survey conducted annually in South Australia since 1991, collects health-related data from a rigorously derived, representative sample of 4,400 households. This study included piloted questions in the 2001, 2002, and 2003 Health Omnibus Survey on the impact of SPCS. Sample size was 9,088 individuals. “Unmet needs,” a short-term outcome relevant to the caregiving period during a life-limiting illness, were tallied. “Moving on,” a long-term caregiver-defined outcome reflecting the caregiver’s adaptation and return to a new equilibrium after the death, was assessed with and without SPCS. Results Thirty-seven percent (3,341) indicated that someone close to them had died of a terminal illness in the preceding 5 years, of whom 949 (29%) reported that they provided care. SPCS were involved in caring for 60% of deceased patients. Day-to-day caregivers indicated fewer unmet needs when SPCS were involved ( p = 0.0028). More caregivers were able to “move on” with their lives when SPCS were involved than when SPCS were not involved (86 vs 77%, p = 0.0016); this effect was greatest in the first 2 years after the loved one’s death. Conclusion At a population level, SPCS were associated with meaningful improvements in short-term (“unmet needs”) and long-term (”moving on”) caregiver-defined outcomes.

Early Integration of Palliative Care into Standard Oncology Care: Evidence and Overcoming Barriers to Implementation

“…An earlier randomized clinical trial by the same author showed improved quality of life and less depression in patients randomized to receive a nurse-led palliative care intervention within 8-12 weeks of a new diagnosis of advanced cancer 4 . Finally, a largescale survey extended those findings to show that early palliative care improved caregiver outcomes 5 .…”

Who provides care for people dying of cancer? A comparison of a rural and metropolitan cohort in a South Australian bereaved population study

“…Country areas with a population of 1,000 or more (based on Australian Bureau of Statistics (ABS) 1996 Census information) are included in proportion to the size of their population. This research group previously verified the content and construct validity supporting the use of this survey tool in palliative care service planning (8) and in assessing the impact of palliative care services on caregiver needs (9). While there is ongoing discussion on the definition or rural (10, 11), for the purposes of this analysis rural is defined as the postcode areas outside the Adelaide metropolitan area.…”

The Right Place at the Right Time: Medical Oncology Outpatients' Perceptions of Location of End-of-Life Care

“…These concerns have also been reported by other patient groups. 12,21 Although there is conflicting evidence about the quality of care received in inpatient settings versus at home, 2 some patients perceive that having access to professional medical care in inpatient settings is essential. People may also feel a sense of security from receiving care at a hospital with which they are already familiar.…”