Rehabilitative Palliative Care
Sláintecare Rehabilitative Palliative Care project - Fintan Fagan CEO explains
For World Hospice and Palliative Care Day, Minister Donnelly welcomes new Sláintecare pilot service for Rehabilitative Palliative Care
From Department of Health
Published on 8 October 2021
Tomorrow, Saturday 9 October, marks World Hospice and Palliative Care Day 2021. The Minister for Health, Stephen Donnelly TD, has welcomed a new, Sláintecare funded, pilot service between St Francis Hospice and the Mater Hospital in Dublin.
The service provides integrated care linking the hospital and community elements of palliative care. This creates a positive impact on patients’ lives, optimising quality of life, and reducing length of stay in hospital.
Patients who are in the general hospital environment are discharged into the community with the support of Occupational Therapy in the Mater Hospital and Physiotherapy in the community. The community-based specialist palliative care physiotherapist can visit patients at home, ensuring that patients can receive services even if they are too unwell to leave their own home.
Minister Donnelly said:
“Sláintecare is about delivering the right care, at the right time, in the right place and this pilot scheme for community-based palliative care embodies each of those principles.
“The service focusses on the entire care pathway of the patient. Integration of services between hospital and community has allowed for a streamlined system, where patients are linked into occupational therapy or physiotherapy, or both.
“Protecting patient time is very important to the clinicians and therapists involved in this service, who prioritise granting patients rapid access to informed care at home, following hospital discharge.
“The Rehabilitative Palliative service has treated over 250 patients to date, allowing patients living with life-limiting conditions to self-manage their condition, and to enjoy the best quality of life in the comfort of their own homes.”
Early review in the hospital setting means that patients’ symptoms are controlled more quickly, functional ability is improved as far as is possible, and discharge planning is managed in a timely and more efficient manner.
An analysis of this service is underway and preliminary findings indicate that patients benefit as they feel empowered, have greater confidence and ability to self-manage symptoms and have improved quality of life.
The Department of Health is in the process of updating the Palliative Care Policy for Adults in 2022 and has recently launched a public consultation to allow the general public to have their say. The public consultation consists of an online survey which can be accessed on the Department of Health’s website.
Minister Donnelly said:
“This public consultation seeks to understand the public’s awareness of palliative care and capture views on current services as well as future priorities for the policy update.
“I would urge everyone to take the time to complete this survey, it is anonymous, takes 5 minutes to complete and is open until Monday 25 October. The survey will provide valuable information on how care for people with a serious and progressive illness is delivered in Ireland, helping to shape the development of palliative care services in Ireland in the future.”
What is the rehabilitative palliative care project?
Rehabilitative Palliative Care optimises wellbeing and enables people to live as independently as possible despite advancing illness. It empowers people to adapt with dignity by providing a support system to help patients cope with changes associated with deteriorating health.
Despite the fact that 3,370 community-based and 1,340 hospitalised patients are seen by specialist palliative care teams every month, rehabilitative palliative care remains a largely underdeveloped component of care. Considering that the number of people in the last year of life will increase by an estimated 27% by 2031, there is an urgent need to develop solutions to improve care.
This project provides an innovative model of rehabilitative palliative care spanning hospital and community. It integrates rehabilitation and enablement into the model of Palliative Care to improve hospital flow, support integrated discharge and build capacity for Health and Social Care Professionals to work in partnership across transitions of care.
Who is delivering this project?
St Francis Hospice and the Mater Hospital, Dublin are providing the rehabilitative service. The All Ireland Institute of Hospice and Palliative Care is providing communications and knowledge transfer support.
The project funded occupational therapist (OT), plays a key role within the palliative care team, highlighting the value of non-medicalised approaches to care. The OT assessment results in the setting of person-centred goals to promote a focus on function rather than symptoms and support self-management, providing a balance of enablement alongside care. Timely discharge home is supported in partnership with the St Francis Hospice based project funded physiotherapist, to ensure smooth transitions of care to home.
The novel community based specialist palliative care physiotherapist provides a rehabilitative approach to symptoms in an effort to improve self-management and reduce inappropriate readmissions. The physiotherapist sees patients in their own homes and in the outpatient department.
Evaluation of the project will use mixed methods.
Who are the project team members?
Prof Karen Ryan
Consultant in the Palliative Medicine, Mater Hospital and St Francis Hospice. Karen is lead investigator on the project and will oversee the operation of the service and the care provided to patients.
Dr Bridget Johnston
Research fellow based in Trinity College Dublin. Bridget is co-investigator on the project. She will oversee the evaluation of the service, and ensure that patient, family and staff opinions of the service are captured for learning and reflection.
A postgraduate student of Health Psychology with the National University of Ireland, Galway, Fódhla is a research assistant on the project. She will analyse both interview and survey data from patients, family and staff to contribute to the service evaluation.
Project funded occupational therapist (OT), Mater Hospital.
Project funded physiotherapist, St Francis Hospice.
The study has been funded by the Sláintecare Integration Fund on behalf of the Department of Health. This project was awarded a research grant to allow for provision of the rehabilitative palliative care service in 2020.