Home Based Palliative Care

dr. Hendri Pangestu, SpAn, KIC

Mohon perhatiannya
 The Pressing Need to Improve End-of-Life
Care
• barriers in access to care that disadvantage certain groups;
• a mismatch between the services patients and families need
and the services they can obtain;
• inadequate numbers of palliative care specialists and too
little palliative care knowledge among other clinicians who
care for individuals with serious advanced illness; and
• a fragmented care delivery system, spurred by perverse
financial incentives, that contributes to the lack of service
coordination across programs and unsustainable growth in
costs.
 TERMINOLOGY
• Palliative care
– is a multidisciplinary approach to specialized
medical and nursing care for people with life-
limiting illnesses.
– It focuses on providing people with relief from the
symptoms, pain, physical stress, and mental
stress of the terminal diagnosis.
• Home-based palliative care
– Attention to patients and families at home is one
of the aspects of the role of palliative care
Home-Based Palliative Care Service
Includes:
• Nursing and medical care to manage patients’
pain and symptoms
• Medical prescriptions, when required
• Education for caregivers and family on symptom
management
• If needed, loan of medical and nursing equipment
such as wheelchairs and oxygen tanks
• Emotional, social and spiritual support for
patients and their families
Background: Objectives:
• People with advanced • We evaluated the impact
illness usually want their of a home based
healthcare where they live palliative care (HBPC)
at home not in the hospital. program implemented
Innovative models of within an Accountable
palliative care that better Care Organization (ACO)
meet the needs of seriously on cost and resource
ill people at lower cost utilization
should be explored.
 Conclusion:
• HBPC within an ACO was associated with significant cost
savings, fewer hospitalizations, and increased hospice use in
the final months of life.
• Give it to me straight, doc. How long do I
have?

– What would be most important to you in your

last chapter?
 The last year of life (ideal)

• Physical comfort
• Spiritual peace
• Love
• Intimacy with family
and friends
• Meaning
• closure
• who want to start a program that serves
patients outside of hospital walls?
• the program that demonstrates value (better
quality at lower cost) has better opportunities
for reimbursement than ever before.
 conclusion
• A Life that its worth
– it is not a wealthy life not an honourable life nor a
long life , but
– a life that you are “a worthy person” but
– a life that you are and a life who makes other people
“worthy” also.
• Attention to patients and families at home is one
of the aspects of the role of palliative care
Terima kasih semoga bermanfaat