Palliative care model for elderly patients by multidisciplinary team and community

Abstract

This qualitative research aimed to investigate a palliative care model for elderly patients through a multidisciplinary team approach and community engagement. Qualitative data were collected using focus group discussions and in-depth interviews involving 74 participants, including elderly patients, caregivers, multidisciplinary team members, health volunteers, and community leaders with experience in palliative care. Data analysis combined content analysis with descriptive statistics.
The results showed that the palliative care model comprised three stages; the assessment phase, the shared decision-making phase and the community collaboration phase. Key mechanisms supporting the palliative care process included: 1) policy support mechanisms from hospitals, 2) operational mechanisms involving committees that connect with the community, 3) communication mechanisms, personnel capacity building, and community-level follow-ups. The success factors identified were: 1) a palliative care center with professional nurses responsible for patient assessment, planning, and coordination within hospital and community teams, 2) a multidisciplinary team competent in palliative care, 3) communication channels, both formal and informal, linking hospitals and communities, 4) active support and participation from hospital administrators, 5) availability of equipment and materials for home-based palliative care. In summary, the key mechanisms and supporting factors that contribute to increased access to services among older patients have led to the development of palliative care models for older adults in tertiary hospitals with comparable contexts, by adapting guidelines and variables to suit the local context.