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Referring patients for domiciliary care

D Graves, A Nash

Nursing Standard (Royal College of Nursing (Great Britain) : 1987)

|March 3, 1993

Summary

Many patients eligible for home palliative nursing care are not referred due to a "conspiracy of silence" among patients, families, and healthcare professionals. Misunderstandings about palliative care services also contribute to underutilization.

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Area of Science:

Palliative Care
Nursing Services
Healthcare Access

Background:

Domiciliary palliative nursing care services aim to support patients at home.
Referral criteria exist, yet a gap is observed between eligible patients and actual referrals.
Understanding barriers to referral is crucial for improving patient access to care.

Purpose of the Study:

To investigate the reasons behind the under-referral of patients meeting domiciliary palliative nursing care criteria.
To identify specific obstacles faced by healthcare professionals and patients in the referral process.
To inform strategies for enhancing access to essential palliative care services.

Main Methods:

A qualitative study involving district nurses and General Practitioners (GPs).
Exploration of perceptions and experiences regarding patient referrals for palliative care.
Analysis of identified barriers to referral.

Main Results:

A persistent 'conspiracy of silence' was identified, involving patients, families, and healthcare professionals.
Healthcare professionals expressed a desire to manage patients independently.
Misunderstandings regarding the scope and role of specialized palliative care providers, such as Macmillan nurses, were reported.

Conclusions:

Addressing the 'conspiracy of silence' is essential for improving palliative care referrals.
Enhanced communication and education are needed to clarify the roles of palliative care teams.
Interventions should focus on facilitating timely referrals to ensure patients receive appropriate home-based support.

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