Palliative Home Care. Veronika Waldboth, Rose Marij Wijnands, Prof. Dr. Lorenz Imhof ; Annual Congress of the SGK and SGHC, Interlaken

Transcription

1 Palliative Home Care Veronika Waldboth, Rose Marij Wijnands, Prof. Dr. Lorenz Imhof ; Annual Congress of the SGK and SGHC, Interlaken

2 Overview of the presentation Part 1: Veronika Waldboth Research project: Evaluation of nurse-led service for Palliative Home Care Part 2: Rose Marij Wijnands Case example: Palliative Care for Mr. Meier* * All names have been changed in order to protect the persons anonymity 2

3 Palliative Home Care Wish to stay at home in end of life conditions (1,2,4) Challenge for community nursing services (6) : Complexity of patient situations Difficult decision making Increased caregiver burden Implementation of nurse led service for Palliative Home Care 3

4 Research project Aim of the reserach project: Evaluation of nurse-led service for Palliative Home Care Evaluation of quality of care Method: Mixed Method-design Semi-structured interviews (n=41) according to Grounded Theory approach (3) Survey evaluating quality of interdisciplinary collaboration (n=41) 4

5 Results: Nurse-led Service for Palliative Home Care Hospital discharge Complex situation Wish to stay at home Home care Direct care Building and maintaining a «network» Professional leadership Ability to act Feeling of safety Continuity of care Emergency situations Use or resources Figure 1: Representation of qualitative results (5) 5

6 Challenges for interprofessional care teams Identification of complex palliative situations To be known and recognised as a service for Palliative Care Information of all parties Communication and professional relationship with physicians High workload 6

7 Mr. Meier Terminal cardiomyopathy Family meeting at the hospital Getting to know each other Assessment of the situation Planning to go home 7

8 Planning the dismissal Local Home Care Hospital bed Contact General Practitioner (GP) Transportation Oxygen Stay in contact with the Hospital Stay in contact with Mrs Meier 8

9 Coming home Visit from Palliative Care Team (Pall.Care) as soon as Mr. Meier gets home to settle in Discussing the emergency plan Checking the medication List of phone numbers 9

10 Later that week. Meeting with Family Meier, GP and Pall. Care Assessment of the situation at home Review of the medication plan Review of the symptoms 10

11 Stable situation Weekly visits of Pall. Care Local Home Care comes 3 times weekly Communication between all the persons involved Weekly visits through volunteer Biweekly visits through GP 11

12 Transition Phone call from Mrs Meier: Situation is changing Contact with local Home Care Visit from GP Visit from Pall. Care 12

13 Mr. Meier dies at home Local Home Care und GP go by Follow up: Phone call with Mrs Meier one week later 13

14 Thank you for the attention. Sponsors: Spitex der Stadt Zürich, Fond für Pflegeforschung in Einrichtungen der Stadt Zürich, KPZ Contact details: 14

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16 References 1. Bell, C. L., Somogyi-Zalud, E., & Masaki, K. H. (2010). Factors associated with congruence between preferred and actual place of death. Journal of Pain & Symptom Management, 39(3), Binder, J., & von Wartburg, L. (2009). Nationale Strategie Palliative Care Bern: Bundesamt für Gesundheit (BAG) & Schweizerische Konferenz der kantonalen Gesundheitsdirektorinnen und -direktoren (GDK). Retrieved from 3. Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks: Sage Publishers 4. Freilinger, F. (2009). Das institutionalisierte Sterben. Sozioökonomische Aspekte des Sterbens. Focus NeuroGeriatrie, 3(1), Imhof, Lorenz; Waldboth, Veronika; Kipfer, Stephanie (2013). Evaluation der Fachstelle Palliative Care der Spitex Zürich. Forschungsbericht des Bereichs Forschung und Entwicklung Pflege, Zürcher Hochschule für Angewandte Wissenschaften. (Unpublished Paper) Winterthur: ZHAW. 6. Schweizerische Gesellschaft für Palliative Medizin Pflege und Begleitung. (2012). Kompetenzen für Spezialisten in Palliative Care. Retrieved November 7, 2012, from 16