The end-of-life population is not a homogeneous population group; it is time to define the population more precisely.
For the purposes of population-based service planning, it is proposed that all people at the end of life (including their family, caregiver[s], and community) be conceptualized as falling within three broad subgroups. The population represented in the conceptual model is 100,000.
, the largest group, are those patients who do not require access to specialist care, as their needs are met either through their own resources or with the support of primary care providers (e.g., generalist medical and nursing services as well as other specialist staff, including oncologists, cardiac services, geriatricians, etc.).
Currently, almost two-thirds of all people whose death is expected fall within subgroup A
and are not seen by a specialist palliative care service prior to their death.
Fewer than a third of patients represented in the model are currently seen by palliative care services.
These patients are distributed between subgroups B
(those patients requiring consultation care) and subgroup C
(those requiring ongoing specialist care). It is not known how they are proportionally distributed between the two subgroups.
In subgroup B
, patients may have sporadic exacerbations of pain or other physical symptoms or may experience social or emotional distress. This temporary increase in their level of need may require access to specialist palliative care services for consultation and advice. They will continue to receive care from their primary care provider.
are those palliative care patients who have been identified as having complex physical, social, psychological, and/or spiritual needs that do not respond to simple or established protocols of care. They usually require highly individualized care plans developed, implemented, and evaluated by knowledgeable and skilled specialist practitioners in partnership with primary care providers. This subgroup is likely to be the smallest of the three subgroups of the population.
See reference for the diagram/model of the level of need within the population of individuals with a life-limiting illness.
Palliative Care Australia. PCC4U. Who needs palliative care? Internet. Accessed on February 21, 2016.