Regional GP's perspective on home-based palliative care
Dr. Claire Hepper writes on her experience of home-based palliative care and the caring@home project in regional Victoria.
As a GP in a regional area with a special interest in community-based palliative care, the resources and education available through caring@home are invaluable. Teaching families and loved ones to be ready to assist in control of breakthrough symptoms at home is incredibly powerful in my experience.
There can be anxiety from healthcare professionals about what should and can be done by community members. These fears can be allayed by caring@home and the Guidelines for the handling of palliative care medicines in community services document that clearly outlines the State and Territory regulations regarding subcutaneous administration as well as safe storage and disposal of medications.
We are fortunate to have specialist palliative care services across Australia. However, we know that, especially for non-malignant patients, recognition of the terminal phase can be difficult. This means that there will be many patients who are not admitted to a palliative care service who might suddenly have symptom control issues at home and their GP is the first point of contact when this occurs.
I am often called to attend patients at home who are in an unstable or terminal phase and the majority are not under the care of a community palliative care service. Whilst I am now more confident in teaching the skills of drawing up and administering medication subcutaneously, the education resources from caring@home will make it much easier for GPs and nurses who are starting to work in community end-of-life care.
In addition to teaching the steps of preparing and administering subcutaneous medication, I believe that the Australia-wide release of these resources will help dispel the myths that tend to exist for both healthcare professionals and in the community about the role of the carer in home-based palliative care.
GPs have struggled for a long time to bridge the gap between these two groups to improve outcomes for our communities. The caring@home project demonstrates the validity of this approach from Australia-wide experts and is a vital development in strengthening community palliative care.
Dr Claire Hepper, MBBS FRACGP, Associate Creswick Medical Centre, Victoria