"She Would Be Flailing Around Distressed": The Critical Role of Home-Based Palliative Care for Patients with Advanced Cancer

Patients with advanced cancer experience significant symptoms, ineffective treatments, and hospice underutilization. Home-based palliative care (HBPC) may fill a service gap for patients who require intensive home management, but are not enrolled in hospice. Even as data emerge on the utilization im...

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Bibliographic Details
Published inJournal of palliative medicine Vol. 20; no. 8; p. 875
Main Authors Calton, Brook A, Thompson, Nicole, Shepard, Nancy, Keyssar, Redwing, Patel, Kanan, Dzul-Church, Virginia, Kao, Helen, Ritchie, Christine, Rabow, Michael W
Format Journal Article
LanguageEnglish
Published United States 01.08.2017
Subjects
Adult
Aged
Aged, 80 and over
Caregivers - psychology
Female
Home Care Services - organization & administration
Humans
Male
Middle Aged
Neoplasms - nursing
Neoplasms - psychology
Palliative Care - organization & administration
Palliative Care - psychology
Patient Satisfaction
Pilot Projects
Quality of Life - psychology
symptom burden
home-based palliative care
metastatic cancer
community-based palliative care
homebound
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Summary:Patients with advanced cancer experience significant symptoms, ineffective treatments, and hospice underutilization. Home-based palliative care (HBPC) may fill a service gap for patients who require intensive home management, but are not enrolled in hospice. Even as data emerge on the utilization impacts of HBPC, other impacts are not as well known. We describe findings of a pilot project in HBPC, Community Bridges (CB), for patients with advanced cancer. We assessed baseline symptom severity, caregiver burden, patient and caregiver program satisfaction, and CB team experience. Seventeen patients were seen. Baseline patient symptom burden and caregiver burden were high. Half of patients died within six months of enrollment. Patients and caregivers reported high program satisfaction and that CBs filled a gap in care. CB providers often served in the role as crisis managers and as trusted reporters for treating oncologists. CBs filled an unmet need for patients with advanced, metastatic cancer who desired ongoing cancer treatment, but were also in need of intensive end-of-life home services.
ISSN:1557-7740
DOI:10.1089/jpm.2016.0354