Background: There is a high burden of morbidity amongst RACF residents with commensurate high rates of mortality. Timely end-of-life care to this vulnerable cohort is predominantly managed by primary care services, but this can be complicated due to limited resources outside usual business hours. Admission to a HITH program can help alleviate issues of medication supply and link RACF staff to hospital resources to support delivery of palliative care to dying residents.
Aims: To assess the role of HITH services to support RACF residents in the palliative care phase.
Methods: Cohort study of RACF residents admitted into a HITH service in metropolitan Melbourne between 1st July to 31st December 2022. Outcomes studied include their demographic and clinical characteristics, mortality outcomes, use of palliative medications, delivery of HITH services, and utilisation of HITH resources; including palliative care services.
Results: 743 residents were admitted into HITH; with 47 people who died whilst within the service, with a median length of stay of 5 days. Common primary causes of death were heart failure (45%), pneumonia (33%) and advanced dementia (22%). All dying patients were prescribed opioids and benzodiazepines; with HITH resources supporting RACF staff via early recognition of the dying patient, education of pressure area care and oral care, utilisation of palliative medications and in selected cases – bridging to community palliative care.
Conclusions: Admittance into a HITH program can help provide additional timely access to healthcare supports amongst frail RACF residents, with a subset of dying patients benefiting from palliative care services.