The role of healthcare support workers in providing palliative and end-of-life care in the community: a systematic literature review

Abstract

Despite the widespread use of Health Care Support Workers (HCSWs) in providing palliative and end‐of‐life care, there is little information available about their contributions towards supporting patients who want to be cared for at home or to die at home. Between January and April 2011, a systematic review was conducted to address two questions: (i) What particular tasks/roles do HCSWs perform when caring for people at the end of life and their families to comply with their desire to remain at home?; (ii) What are the challenges and supporting factors that influence HCSWs’ ability to provide palliative and end‐of‐life care in the community? Databases searched for relevant articles published between 1990 until April 2011 included CINAHL, EMBASE, PsychINFO, British Nursing Index, Web of Science, Medline and ASSIA. In total, 1695 papers were identified and their titles and abstracts were read. Ten papers met the eligibility criteria of the study. After the methodological quality of the studies was appraised, nine papers were included in the review. Judgements regarding eligibility and quality were undertaken independently by the authors. The findings indicate that HCSWs invest a great deal of their time on emotional and social support as well as on assisting in the provision of personal care. They are also involved in providing care for the dying, respite care for family members and offer domestic support. Although it is important to acknowledge the many positive aspects that HCSWs provide, the findings suggest three challenges in the HCSWs role: emotional attachment, role ambiguity and inadequate training. Support factors such as informal peer grief‐support groups, sense of cohesiveness among HCSWs and task orientation enabled HCSWs to overcome these challenges. To conclude, induction and training programmes, a defined period of preceptorship, appropriate support, supervision and clearly defined role boundaries may be helpful in reducing the challenges identified in HCSWs’ roles.

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The provision of emotional labour by health care assistants caring for dying cancer patients in the community: A qualitative study into the experiences of health care assistants and bereaved family carers

“…A recent systematic literature review of the role of HCAs in providing palliative and end-of-life care in the community has identified that the provision of emotional support is a key aspect of their role (Herber & Johnston 2013). Originally defined by Hochschild (1983) as 'the management of feeling to create a publicly observable facial and bodily display,' (Hochschild, 1983, p.7) the concept of emotional labour has been applied to nursing (Bartram et al 2012;Gray 2009;Hayward & Tuckey 2011;James 1992;Schell & Kayser-Jones 2007;Skilbeck & Payne 2003;Smith 1992;Yang & Chang 2008) in general, and more specifically to HCAs involved in community palliative care work (Munday 2007;Ferguson et al 1998).…”

Gaps in Understanding the Experiences of Homecare Workers Providing Care for People with Dementia up to the End of Life: A Systematic Review

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