Evaluating flexible models of care for terminally ill people living at home alone

Objectives
Community and home-based palliative care services are facing increasing challenges in service provision due to an ageing population, an increase in the number of people living alone who require care, a decrease in the availability of family caregivers and a preference to be cared for and die at home, This study explores approaches to achieving the provision of appropriate home-based care for people with palliative care needs who live alone in order to allow them to live and die at home and reduce the need for end-of-life hospital admissions.

Methods
This proposal will implement and evaluate two recommendations arising from a national scoping study: [Model 1] installing alert-link systems or personal emergency systems that would maintain clients' need for independent living and linking them to service providers at any time they have a need; [Model 2] provision of targeted in-house respite where a care aide assists the clients looking after themselves. Sixty participants will be recruited from Silver Chain Hospice Care [SCHC] clients. The design consists of a pilot randomised controlled trial with a third of clients receiving Model 1, another third receiving Model 2 and the last third receiving current routine care.

Results
The analysis will assess the impact of the proposed models of care on outcomes such as improvements in care in terms of physical and emotional support, symptom distress and satisfaction with care.

Conclusion
The project will have a considerable significance in building models of community support and service provision for this growing population