Health Care Support Workers need more training and support to provide end-of-life care

By Oliver R. Herber, RN, BScN, MCommH, S-EANS
School of Nursing & Midwifery University of Dundee, Scotland, United Kingdom

Despite the widespread use of Health Care Support Workers (HCSWs) in providing palliative and end-of-life care, there is little information available about their contributions towards supporting patients who want to be cared for at home or to die at home.

What did you do in your research?
We conducted a literature review to address two questions: (i) What particular tasks ⁄ roles do HCSWs perform when caring for people at the end of life and their families to comply with their desire to remain at home?; (ii) What are the challenges and supporting factors that influence HCSWs’ ability to provide palliative and end-of-life care in the community? In total, 1695 papers were identified and their titles and abstracts were read. Nine papers were included in the review.

What did you find out?
The findings indicate that HCSWs invest a great deal of their time on emotional and social support as well as on assisting in the provision of personal care. They are also involved in providing care for the dying, respite care for family members and offer domestic support. Although it is important to acknowledge the many positive aspects that HCSWs provide, the findings suggest three challenges in the HCSWs role: emotional attachment, role ambiguity, and inadequate training. Support factors such as informal peer grief-support groups, sense of cohesiveness among HCSWs and task orientation enabled HCSWs to overcome these challenges.

What are the take-home messages?
Induction and training programs, a defined period of practical training, appropriate support, supervision and clearly defined role boundaries may be helpful in reducing the challenges identified in HCSWs’ roles.

To learn more about these findings contact
Oliver R. Herber.

Full Journal Article
Herber, O.R. and Johnston, B.M. (2012). The role of healthcare support workers in providing palliative and end-of-life care in the community: a systematic literature review. Health and Social Care in the Community, in press. Epub ahead of print.