P_CS_20 Carers Giving Subcutaneous Injections in Community Palliative Care

Palliative care services strive to support patients to live and to die within a setting of their choice, usually at home, with optimal symptom control and with a pattern of care that is also supportive of the carers/families (East Midlands Cancer Network 2012). Uncontrolled pain and symptoms have the potential to prevent patients being able to die at home (East Midlands Cancer Network 2012), especially when patients are no longer able to tolerate oral medication. Whilst the government has allocated funding to educate community staff in palliative care (Department of Health 2001), Liverpool Care Pathway (Ellershaw & Wilkinson 2003) and the Gold Standard Framework (Thomas 2003), little has been done to recognise the input required from informal carers to enable this process to succeed. The input of informal carers is a fundamental resource to aid success in achieving this. East Midlands Cancer Network (2012) suggests that there may be times when it would be helpful for them to administer subcutaneous injections to ensure patients symptoms are well managed at home. This role is promoted by others in palliative care (Lee and Headland 2003, Bradford and Airedale PCT 2006, Twycross and Wilcox 2011). In addition, it is common practice that carers administer other subcutaneous (s/c) medication such as Clexane/ Insulin. National documents support the role of effective symptom control in achieving preferred place of death (Department of Health 2008).

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