Models of end-of-life care in the home environment

Abstract

People with advanced heart failure spend most of their time living in the community, therefore could benefit by improved access to palliative care in the home. Hospice and home-based palliative care are the primary mechanisms for provision of such care for community-dwelling patients with heart failure. While several barriers to hospice care exist for heart failure patients, significant evidence for improved patient outcomes for home-based palliative care exists. Improved patient satisfaction as well as physical and psychological symptom control has been demonstrated along with considerable reductions in costs of medical care for patients with advance heart disease enrolled in home-based palliative acre programs. Despite this evidence for effectiveness among patients, caregivers of heart failure patients may continue to experience high levels of burden.