Provision of Hospice Palliative Care in LTC Facilities

• Main Authors: Li-Chun Liu, 劉俐君
• Other Authors: Shu-Chuan Yeh
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/y4wxhv

碩士 === 國立中山大學 === 企業管理學系醫務管理碩士班 === 106 === Palliative care has become a global public health concern, prompting countries to actively promote relevant policies. This is a pilot study on the coping measures of long-term care institutions when providing palliative care. The objective is to determine the current implementation status of palliative care services in various types of long-term care institutions, the palliative care expertise of long-term care staff, and the outcome of receiving relevant palliative care training programs. This study also explores the implementation of community-based palliative care in long-term care institutions in response to the government’s promotion of the topic. This study conducted in-depth interviews at 8 long-term care institutions in southern Taiwan, including nursing homes, health maintenance centers, and home care institutions. To pursue sample variety, the participating institutions were divided into independent and affiliated types. The variation among these institutions was compared through the outcomes of interviews. For patients in long-term care institutions, the majority of chronic diseases associated with aging overlap with the 10 diseases covered by the national health insurance, including several highly diagnosed diseases: dementia, cerebral degeneration, heart disease, chronic renal failure, and renal failure. Most of these diseases are irreversible, and patients’ conditions only deteriorate with age. Because these patients will eventually become the target audience of palliative care services, the palliative care demands of long-term care institutions must be assessed. At present, long-term palliative care policy has become community-focused to encourage home-based palliative care. The intervention of palliative care measures improves the life quality of patients with late-stage diseases, embodies the concept of aging in place, and reduces the cost of social care and medical expenses. However, the provision of community palliative care still contains numerous problems, such as the inadequate palliative care professionalism of long-term care personnel and the obstacles of home-based palliative care (category B) induced by ineffective service output that engenders unfavorable outcome. Additionally, numerous restrictions still exist in the palliative care services provided by long-term institutions, requiring collaboration among multiple parties for resolutions and amelioration.