Miller EM, Porter JE, Peel R. Palliative and End-of-Life Care in the Home in Regional/Rural Victoria, Australia: The Role and Lived Experience of Primary Carers.
SAGE Open Nurs 2021;
7:23779608211036284. [PMID:
34869854 PMCID:
PMC8642066 DOI:
10.1177/23779608211036284]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/11/2021] [Accepted: 07/11/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction
Palliative support services (generalist or specialist) can provide
much-needed assistance to carers who are providing palliative and
end-of-life care in their homes, but access to such services in regional and
rural areas of Australia is poorly understood.
Objectives
This study aimed to explore the role and lived experience of primary carers
who are providing palliative and end-of-life care in the home in
regional/rural Victoria, Australia.
Methods
Nine female participants, of whom six were bereaved between 7 and 20 months
were interviewed using a semistructured interview technique. Each interview
was audio-recorded, transcribed verbatim, and analyzed thematically.
Results
Two themes emerged: “Negotiating healthcare systems” which
described the needs for multidisciplinary supports and “The caring
experience” which discussed daily tasks, relationships, mental
and physical exhaustion, respite, isolation, medication management, and
grief and loss. Findings show that regional/rural carers have an added
burden of travel stress as well as feeling overwhelmed, isolated, and
physically and emotionally exhausted. Carers would benefit from greater
flexibility for short-term respite care. The engagement of specialist
palliative care services assisted the participants to navigate the health
care system.
Some participants did not understand the value of palliative care,
highlighting the need for general practitioners to conduct early
conversations about this with their patients. Education is needed to build
capacity within the primary palliative care workforce, confirming the
importance of timely referrals to a specialist palliative care practitioner
if pain or symptom control is not effectively managed.
Conclusion
Providing palliative and end-of-life care in the home is an exhausting and
emotionally draining role for unpaid, primary carers. Multiple supports are
needed to sustain primary carers, as they play an essential role in the
primary health care system.
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