When PhD candidate Claire Marshall looked into rural palliative care services, she found a model requiring urgent change. She shared her research findings at the 2023 Oceanic Palliative Care Conference.

Approximately 30 per cent of the Australian population live in regional and rural areas.

From those who live in small towns with limited services to people in isolated regions far from healthcare, the 8.4 million people who live in Australia’s regional and rural communities face several barriers to accessing palliative care, barriers include:

• Geography
• Difficulty recruiting and retaining staff
• Difficulty providing education to healthcare staff
• Fragmented service delivery
• A lack of clarity in the referral process to specialist services
• Dual personal and professional relationships among rural care providers

“While there’s been significant improvement globally in the delivery of and access to specialist palliative care services for people in urban communities, challenges continue to limit the provision of high-quality palliative care for people in rural settings,” says Claire Marshall, PhD candidate at the University of Technology Sydney.

What rural communities need in an updated palliative care model

Marshall set out to discover what people in rural communities need in a palliative care model – and found a number of ways in which improvements can be made.

“Our results signal that a multidisciplinary team approach, integrated across local healthcare settings and using information systems and care planning, optimises rural palliative care,” Marshall says.

“We also found that care is best delivered using care coordination, overseen or led by specialist palliative care clinicians.”

People in rural areas who need palliative care services often say they want to spend as much time at home as possible. “This requires access to appropriate home supports,” says Marshall.

She adds that communities need to be educated in end-of-life care. “Patients and families require information and support to optimise their ability to traverse their end-of-life journey.”

How to bring positive changes into palliative care to meet the needs of rural communities

Marshall has identified several changes that could be made in rural and regional settings, which could help to meet the needs of palliative care patients.

The first of these possible solutions is the infrastructure to give rural and regional people reliable and appropriate access to telehealth services. “There is a need for dependable telecommunication infrastructure and for devising virtual health strategies that meet the needs of the ageing population,” says Marshall.

It’s also important to keep the context of the patient’s geographical location at top of mind. “Working within the resource and geographic realities of the setting is critical,” Marshall says.

“When developing care plans for rurally located patients, the focus must remain on understanding the rural context, enhance existing capacity and harness local problem solving.”

It’s also important that this research into improving the quality of and access to specialist palliative care services is continued. Marshall says, “There is a need for specialist palliative care services and university research centres to partner with rural palliative care services to guide the research process and deliver high quality translational data and escalate their findings to policy makers.”

The innovative short course that’s providing patients and carers with the tools they need to navigate regional palliative care

The 2023 Oceanic Palliative Care Conference was an opportunity to hear about not just intriguing research findings, but also the initiatives undertaken around the country to improve palliative care.

One example of this in a regional setting came from the mid-north coast of New South Wales, where an innovative short course has been designed to help patients, carers and families navigate life in palliative care.

“The SHINE program is all about empowering caregivers and patients with the knowledge, skills and confidence to shine,” says Emma McLeod, Palliative Care and Oncology Clinical Nurse Specialist at Forster Private Hospital.

SHINE is a four-week course for carers and patients diagnosed with a life-limiting illness, giving them the knowledge needed to access and utilise support in a rural setting.

It includes a multi-disciplinary approach with physiotherapists, occupational therapists, social workers, mindfulness specialists, GPs and the local outpatient and inpatient palliative care teams.

Topics covered in the SHINE sessions included carer training, symptom management, advanced care planning, legal documents, mindfulness, exercise programs, and the chance to connect with other patients undergoing similar experiences.

As with all palliative care patients, those who live in the regional and rural parts of Australia need the same access to patient-centred care as their urban cousins.

Video recordings from 23OPCC are now available to watch on demand via the 23OPCC Education Hub. Recordings are available free of charge to delegates as part registration. Subscriptions can also be purchased for between $200 and $400. More info and access - HERE.