A lens on international palliative care nursing in the community

Many countries, including the UK, take extensive measures to ensure that those who are dying are cared for at home, which is often the preferred place of care and death (Gomes, 2018). In other countries, there are limited options of hospitalisation and, therefore, home is the default place for end-of-life care (EoL) and death. Based on personal experience of teaching in developing countries, some of the challenges related to EoL care at home are as follows:

There are different models of community palliative care, and the International Association for Hospice and Palliative Care (IAHPC) outlines 12 of these, but the three main ones are discussed here (IAHPC, 2021). Application of these models differs among countries, as well as within countries.

Mainly delivered by nurses who are dually trained in palliative and community nursing, the success of this model depends on support from local GPs. Here, palliative care is delivered to terminally ill patients in their homes. The frequency of visits depends on patient needs and family support. Local palliative care services often provide or lend equipment, such as beds, to improve the comfort of dying patients. Although this service is one of the most useful ones for the patient, it comes with a huge cost to operationalise, and, without strong GP support, it is difficult to deliver. Further, it is hampered by a lack of succession planning, as other nurses or doctors are not trained to acquire palliative care skills.