PP-39 PALLDEM-Homecare: a scoping review of interventions to support homecare workers to provide palliative and end-of-life care, and implementation considerations

Introduction Social homecare workers play a central role in providing palliative and end-of-life care to people at home, but they often encounter challenges and can feel disempowered. While some interventions have been developed to support homecare workers, the factors that influence their implementation are not clear. Aims To explore contextual factors that may influence the implementation of interventions to support homecare workers to provide palliative and end of life care. Methods A scoping review of evidence on intervention types and contextual factors affecting their implementation. Findings are mapped onto the four domains of the Practical, Robust, Implementation and Sustainability Model (PRISM) to identify the extent of evidence on contextual factors. Results Preliminary Results show relatively few papers describe interventions to support homecare workers provide palliative and end-of-life care, and fewer describe contextual factors of implementation. Education and training programmes are the most common intervention types, followed by resources such as checklists. Most common contextual factors influencing their implementation include the homecare agency characteristics and homecare worker views of the intervention. Few studies considered the influence of clients’ or managers’ characteristics or perspectives on interventions, nor the influence of the external environment. Conclusion There is scarce evidence on contextual factors that influence the implementation of interventions to support homecare workers provide palliative and end-of-life care. Redressing this evidence gap is a priority to empower homecare workers and better prepare the sector to respond to increasing demand, ensuring people can live and die at home with the highest quality homecare. Impact The limited evidence found highlights a missed opportunity to support the homecare sector’s response to the escalating prevalence of serious and increasingly complex illness. However, the contextual factors that have been identified should be considered for future implementation planning.