Providing palliative day care for non-malignant conditions

There is increasing pressure to provide palliative care to patients on the basis of need rather than diagnosis but there is a paucity of practical information on how to provide support to those with nonmalignant conditions.

To examine the feasibility of providing hospice day care to patients with non-malignant conditions.

A year-long pilot project was conducted and then analysed.

Twenty-eight patients out of a possible 52 who fitted referral criteria attended day care during the year, 16 were discharged and four died. Attendance appeared generally acceptable to patients who accepted the invitation but was often sporadic due to acute exacerbations of illness.

With appropriate staff education, careful referral criteria, access via clinical nurse specialist (CNS) screening, an overt discharge policy and close collaboration between CNS and specialist palliative care services, we were able to offer palliative day care to a small number of selected patients with non-malignant conditions.

The project did not overwhelm the service, it had negligible impact on the number of inpatient admissions and, at first glance, appeared to be resource neutral.