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Advancing the ERHA’s Oncology Home – Based Palliative Care initiative – St. Andrew / St. David

Advancing the ERHA’s Oncology Home – Based Palliative Care initiative – St. Andrew / St. David. Presented by: Florence Hercules – Arthur RN. RMN. LM Dip. Health Visiting (Retired) Date: Saturday 22 nd October, 2011. Order of presentation. Mission Vision Objectives Introduction

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Advancing the ERHA’s Oncology Home – Based Palliative Care initiative – St. Andrew / St. David

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  1. Advancing the ERHA’s Oncology Home – Based Palliative Care initiative – St. Andrew / St. David Presented by: Florence Hercules – Arthur RN. RMN. LM Dip. Health Visiting (Retired) Date: Saturday 22nd October, 2011

  2. Order of presentation • Mission • Vision • Objectives • Introduction • Background • Care Model • Intervention • Service • Referral Structure • Challenges • Conclusion

  3. Vision Statement In collaboration with caregivers, the home – based oncology team strives to provide the appropriate palliative care which will impact positively on clients’ well being within the confines and comfort of their own homes.

  4. Mission Statement St. Andrew/St. David Home Based Oncology Palliative Care Programme is committed to provide an equitable and supportive Health Care service focused on the delivery of pain relief and symptom management to clients. A team approach is adopted to enhance collaborative partnership with care givers to ensure that the dignity and autonomy of their loved ones are sustained as they cope and manage the end of life stage

  5. Objectives • To provide pain and symptom management to clients whose disease process is irreversible. • To help clients living with cancer, by improving their quality of life and end of life experience. • To assist families and caregivers as they cope with and manage the end of life stage of clients with cancer. • To ensure comfort and maintain dignity. • To relieve the current pressures on the cancer care system.

  6. Introduction “ Cancer conjures up fears of a silent killer that creeps up on us without warning. Cancer, evoking such desperation that it has become a metaphor for grief and pain, a scourge straining our intellectual and emotional resources. The numbers are such that each of us will be touched either as a patient, a family member or friend.” ( GroHarlem Brundtland, Director General of W.H.O, Geneva, May, 2002)

  7. Introduction • Palliative Care referred to as ‘Comfort Care’ is primarily aimed at providing relief to a terminally ill client through pain and symptom management. • The inauguration of the home – based oncology palliative care services marked an impressionable and historic milestone at the Eastern Regional Health Authority. • Maintaining a specialized human feeling for the living was achieved thus reinforcing the main focus of the programme.

  8. Background • From a health care provider’s perspective there was an inherent need to care for clients with advanced cancer. • A six month pilot project was launched in St. Andrew/St. David on the 18th January, 2007 to identify the way forward collaboratively with St. Elizabeth’s Health Care Team, Canada and National Oncology coordinator.

  9. Background • In September 2007, The National Oncology Programme (N.O.P.) model for community palliative care adopted. • Implementation of processes needed for effective home care by Community Health Professionals’

  10. NOP Home Care Programme Care Model Other Regional Programmes Nutritionist/Dietician Facility Services . Hospital . NRC . NOP Partner Nurses/ Enrolled Nursing Assistants Primary Nurse Community Laison Unit Regional Community Oncology Nurse CLIENT Community -based Services . Support groups . Church organizations . Other local services Family Caregivers & Respite Services Physician Case Management Services Pharmacist Social Worker Aids to Daily Living Services

  11. InterventionLow Cost/High Impact • Medical • Nursing • Nutrition • Social work • Partnership • GAPP • NIS • Social Services • Police Services

  12. Service • Pain and symptom management.

  13. Service • Community and home – based. • Primary care services. • Largely nursing in character. • Assessment and intervention by social worker, medical officer and nutritionist. • Home visiting Monday to Friday 8am – 4pm.

  14. Referral Structure • Residents of St. Andrew/ St. David. • Referrals by the Oncologist. • Treatment must be deliverable in – home. • Client’s consent. • Family members’ participation. • Safe and suitable environment identified.

  15. Challenges • Expensive appropriate treatment. • Low priority to clients who access treatment centres also clients who access social services.

  16. Conclusion • Clients are now afforded the choice to die at home in comfort with support from family members whereas the former approach to care of the oncologic clients in end stage was facilitated at secondary institutions. • This in effect ignored the social, psychological, spiritual and cultural elements of the client’s illness thereby depriving them to enjoy their last days in their own home setting. Moreover, there has been tremendous impact on the already overburdened health care system.

  17. Thank You

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