Priority 8 from the Palliative and end of life care PSP

UNCERTAINTY:  What are the benefits, and best ways, of providing care in the patient’s home and how can home care be maintained as long as possible? Does good coordination of services affect this?   (JLA PSP Priority 8)
Overall ranking 8
JLA question ID 0026/8
Evidence

Gomes B, Calanzani N, Curiale V, McCrone P, Higginson IJ. Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD007760. DOI: 10.1002/14651858.CD007760.pub2.
Health Research Classification System category  Generic
Extra information provided by this PSP
Original uncertainty examples Do you think it's important that the patient stays in their own home as long as possible & what support & care would we have?  ~  With the increasing numbers of frail older people coming into Acute care needing 24hr support, how will we support their preferred place of care/death when it is home without 24-hr community care?   Support - more support whilst in community social service input?  ~  Currently the burden of care falls squarely on family members. When will free nursing care be available at home, preventing admittance to nursing homes or hospital, to those who are palliative?
Submitted by Professionals x 2  ~  Carers x 1  ~  Members of the Public x 1
Outcomes to be measured Change in symptoms; change in management of symptoms; Patient Satisfaction; health related quality of life; health related cost.
PSP information
PSP unique ID 0026
PSP name Palliative and end of life care
Total number of uncertainties identified by this PSP. 83  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 November 2014