27 Palliative care day services operate through therapeutic relationships

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Abstract

Introduction

Marie Curie Palliative Care Day Services have been developed to support people with life-limiting illness who live in their own home. Patients attend on a regular basis, typically receiving a mix of clinical and social care. Despite their popularity and general satisfaction (Kernohan et al, 2006), there is ambiguity concerning the content.

Aim

To provide in-depth knowledge of day services by mapping services at three Marie Curie Hospice sites.

Methods

We: reviewed the records of a 25% random stratified sample of new patients attending in 2015, providing evidence on the content of care; undertook focus groups with staff, focusing on their knowledge and experience of providing Day Services.

Results

The three services are characterised by:

Results

• wide-ranging care that spans physical, psychological, emotional and social domains;

Results

• care for both patients and their informal carers;

Results

• the development of patient-patient and patient-professional therapeutic relationships

Results

• extremely proactive care, based on regular assessment and follow-up;

Results

• being able to respond to a majority of identified needs ‘in-house’;

Results

• where such response in unavailable, ensuring onward referral and follow-up;

Results

• extensive liaison with other health and social care providers.

Conclusion

Findings contribute to the limited evidence base on the organisation and content of day services. They highlight how these services are firmly rooted in, but extend beyond, their immediate context to promote holistic, patient-centred care. This care is premised on meaningful therapeutic relationships, which form between patients themselves and between patients and day services staff.

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