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P-81 Therapy and wellbeing with GRACE – transforming our hospice-based services following closure due to COVID-19
  1. Kate Martin
  1. Nottinghamshire Hospice, Nottingham, UK


Background GRACE stands for Goalsetting, Reablement, Assessment, Complementary Therapy and Emotional Support. Person-centred goal setting focuses on patients’ priorities for normality and functional independence (Wosahlo, 2013). Among patients’ end-of-life concerns, fear of functional decline frequently eclipses fear of impending death (Cheville, 2001). Rehabilitation has been shown to reduce the impact of symptoms such as pain and anxiety and to improve functional status and quality of life (Javier & Montagnini, 2011). The model also allows for early identification of people approaching the end-of-life and initiating discussions about preferences for end-of-life care; care planning: assessing needs and preferences, agreeing a patient and carer care plan; and coordination of care.

Aim To optimise function and wellbeing to enable people to live as well and independently as possible within the limitations of advancing illness.

Methods 2019-2020: wellbeing days piloted. May-August 2020: literature review and remodelling. Sept-December 2020: workforce planning, training in Support Needs Approach for Patients (SNAP) intervention. Jan-May 2021: recruitment, process planning.

Results The outcome measures utilised are IPOS and AKPS plus goals achieved and advance care planning. It is too early to truly evaluate the impact of our new approach.

Conclusion GRACE is a person-centred approach with a focus on reablement and wellbeing. It allows for earlier identification and support of those in their last year of life.

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