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Difficulties experienced with hospice providing palliative care at home (00HDC11970)
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(00HDC11970, 8 December 2002)
District nurse ~ Hospice ~
Palliative care ~ Continuity of care ~ Co-ordination of providers ~
A woman complained on behalf of her family about the services
provided to her father at home by a hospice and a principal nurse.
The complaint was that the hospice: (1) provided inadequate pain
relief; (2) provided inappropriate nursing care as (a) the
patient's dehydration was not addressed, (b) the patient's mouth
was in poor condition, (c) napkins were not supplied, and the
patient's sheets needed changing regularly, (d) the patient was not
provided with liquid foods, cream for bed sores, or nursing care on
a daily basis, and (e) the nursing care at night was inadequate;
and (3) there was not proper liaison between and co-ordination of
health care providers.
The complaint also alleged that the principal nurse did not
provide the necessary care when the patient required it.
The Commissioner reasoned that:
1 although the nursing care provided to the patient was
generally appropriate and of a high standard, there were concerns
that the communication, liaison and provision of care between the
people and organisations responsible for providing care was not
2 the delay in the provision of services was not optimal
given that there were only 15 days between the patient's referral
to the hospice and his death;
3 the involvement of the patient's family could have been
more effective with regard to the provision of mouth cares and
management of faecal incontinence; and
4 the reference to a "24-hour service" meant that the
service was available throughout the day, but did not mean the
patient would be provided with constant hospice care.
It was held that the hospice and the principal nurse did not
breach Right 4(1) with regard to any aspect of the complaint, but
that the reference in the hospice's brochures to a "24-hour
service" should be clarified.
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