Health and social care collaboration: The development of community-based palliative care in Hong Kong

Abstract

BACKGROUND: End-of-life care (EoLC) is considered an essential agenda around the world due to the growing number of deaths. An advanced illness brings physical, psychological, social and spiritual distress to both the patient and the family. Thus, collaborative, holistic care from health and social care professionals is always demanded. Funded by the Hong Kong Jockey Club Charities Trust, an initiative to develop evidence-based community EoLC models is carried out from 2016 to 2018. AIMS: This study aims to evaluate the effectiveness of the community EoLC offered by four community NGOs. Social workers, with other support staff and close collaboration with the medical team in the hospitals, were the key drivers of the care model. METHODS: The outcome and impact of EoLC on both patients and caregivers were measured at three time points. The assessments included physical symptoms, psychosocial concerns, spiritual concerns and practical needs of patients, as well as the caregiver strain and well-being of the caregivers. Family relationship and post-death bereavement reactions were measured as well. The utilisation of health care services by the patients was also compared with the other patients in the community. RESULTS: Although the patients under EoLC were expected to have deterioration in health, patients were found to have statistical improvement in physical symptoms and other outcomes. Similarly, the utilisation of health care services was reduced as well. At the same time, family caregivers had improvement in outcomes. DISCUSSION / CONCLUSION: The community EoLC is found to be a viable and effective intervention for families with patients with advanced illness. Social workers in the community can collaborate with the healthcare team in the hospital to provide seamless care for families touched by advanced illness.