Background A Health Promoting Palliative Care philosophy, Kellehear (1999), was embraced to develop medication safety in the palliative care home setting in response tothe widespread informal practice of carers administering subcutaneous medications, especially in the last few days of life. Evaluations have demonstrated a legal and ethical framework for standardised practices enabling patients choices in place of care and death however a carer survey has been conducted to gain carer’s perspectives.
Aim To ascertain how palliative carers feel about participating in administering subcutaneous medications in the home setting during end of life care.
Methods Carers who accepted the invitation to participate, were surveyed by telephone 3–6 months post client death. Questions were provided pre-interview – 9 closed and 4 open-ended.
Results 100% carers felt they worked in partnership with the team to manage symptoms.
100% believed training and support was easy to understand and inspired confidence. 81% felt they were able to give medications confidently– 19% exercised their right to not participate. Comments demonstrated the support, reassurance, and increased self-worth of the carers developing a great sense of achievement. “Couldn’t have been a happier time for me that he died in bed with his arm around me…..the grandkids were here…. we would all laugh together…” Negative aspects were around bereavement.
Conclusion Common themes demonstrated the importance of place of care an d death, pain control, access and timing of information and support, medication safety, exercising Choices, self-confidence, knowing and controlling care of dying and death, and bereavement care.
Kellehear A. Health promoting palliative care. Melbourne: Oxford University Press, 1999.
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