Improving choices for community palliative care: a prospective 2-year pilot of a live-in support person

• Published in: Progress in palliative care 2005-10, Vol.13 (5), p.257-262
• Main Authors: Currow, David C., Easterbrook, Sally, Mattes, Rosemary
• Format: Article
• Language: English
• Subjects: CAREGIVERS; COST EFFECTIVENESS; HOME CARE SERVICES MODELS; ORGANISATIONAL PALLIATIVE CARE; PROSPECTIVE COHORT STUDY
• ISSN: 0969-9260; 1743-291X
• DOI: 10.1179/096992605X75877

Introduction: This prospective pilot evaluates a free-to-client, live-in support person (LISP) for community palliative care. People who needed additional support to be at home rather than in hospital/hospice were included. A LISP from 0900 Monday to 1600 Friday was offered to palliative clients for an initial 2-week placement. Patients and Methods: Over 24 months, a sequential cohort was evaluated. Hospital admissions avoided and discharges facilitated, costs and potential uptake rates were gathered. Caregivers provided feedback 3 months after the placement. Results: The LISP had 49 long-term placements with 44 clients saving 409 bed days. Median placement was short (5 days; range, 2-33 days). Only 8 clients used the LISP around-the-clock. Net potential savings (allowing for caregiver costs) were AU$11,379 annually. Qualitatively, caregivers appreciated the re-assurance offered. Discussion: This pilot study supports the need for a randomised controlled trial to evaluate further the role of the free-to-client, LISP for community palliative care. Evaluating new models of service delivery for patients and caregivers is imperative in palliative care. The LISP improves choices for people in a cost-neutral way if existing services can be substituted.