Authors (including presenting author) :
Chiu LT (1), Karn KY (2), Lee KY (1), Fung SY (3), Sha KY(3)
Affiliation :
(1)Community Nursing Service (CNS), United Christian Hospital (UCH)
(2)Nursing Services Division (NSD), United Christian Hospital (UCH)
(3)Medical & Geriatric (M&G) Department, United Christian Hospital (UCH)
Introduction :
The frail people are suffering functional decline, impaired mobility, social withdrawal and also increased vulnerability to disease and death. Evidence showed that frailty was an indicator for initiating palliative care. Currently, palliative care is provided to the patient with cancer or advanced chronic disease. However, there are limited end-of-life (EOL) services to explore the life expectance for the stable frailty patient with multi-comorbidities living at home. In order to fill this service gap, a pilot program is initiated with the aim to provide an EOL care for the stable frail patient.
Objectives :
•To provide a holistic support for the frailty elderly at home
•To explore the life expectancy and wish of the frailty patient and their relatives
Methodology :
This is a prospective pilot study. The patient is screened and recruited under the inclusion criteria from Apr to Dec 2020. The inclusion criteria are: 1) under CNS and follow up at UCH M&G Team; 2) stable chronic disease condition and reached the stage that cannot reverse their health condition even by active and intensive medical treatment; 3) need continuous medical and nursing care according to their total dependency on daily activities. Besides the basic nursing care is continuous supported by community nurse (CN), the end-of-life approach intervention with a holistic support especially on psychological is also provided to the patient and their relatives. The life expectance and wishes will be discussed with the patient and their relatives if appropriate.
Result & Outcome :
Total 4 patients are recruited. All of them are female with the mean age 99. The frailty score of them is around 7-8. They are suffering from stroke and advanced dementia. All of them are bedbound patient and 3 of them are non-communicable. It is so encouraging that the relatives are willing to seek information and understanding of the end-of-life care. As a result, the Advanced Care Plan and Non-Hospital Do-Not-Attempt-Cardiopulmonary-Resuscitation (DNACPR) are signed for all of the recruited patients (100%) according to patient and their relatives wishes.
Conclusion
This pilot program was launched to fill the service gap for the stable frailty patient in community. The positive result proved that the successful of the end-of-life care approach for the stable frailty patient. Thus, UCN CNS will continue to provide the right care for the right patient at the right time in community on the way forward.
