Abstract
IntroductionOlder people living with advancing frailty (OPWF) are an unrepresented, often unheard population, and yet are predicted to become one of the largest uses of palliative care. By understanding their needs, services are better able to respond to what matters most to OPWF and their unpaid carers.AimsTo understand the met and unmet palliative care needs and care experiences of OPWF as they approach end-of-life.MethodsNested in a wider mixed-method study,1 we purposively sampled n=26 community dwelling OPWF, who were supported by n=15 unpaid carers, across three diverse areas of England (Bradford, Northumbria, Sussex). Participants will undertake up-to three serial interviews (October 2022 – December 2023) using a case study approach. Thematic analysis2 will be used to understand participant needs, change over time, and service response.ResultsAt the time of writing, round 1 data has been informally analysed. Nascent themes include 1. keeping on living, for example patient-led adaptations and a ‘make do’ attitudes, 2. accessing care closer to home and the importance of care continuity, 3. loneliness and social connectedness, 4. support from, burden on and needs of unpaid carers, 5. physical needs, including the impact of multimorbidity, and 6. the desire to avoid hospitalisation. Round 2 interviews are now complete. By the time of the conference, all interviews will be completed and analysed.ConclusionThis study will enable identification of the important components and composition of services that meet the palliative care needs of OPWF across care sectors.ImpactThe results of this study, alongside findings from the wider study, will be used to generate descriptions of the key features of effective multi-agency community palliative care services for OPWF, and to co-produce a range of practical tools to reduce inequality in end-of-life care, support meaningful integration across care sectors, and care closer to home.ReferenceThe PALLUP Study: Improving home-based palliative care for older people https://www.surrey.ac.uk/research-projects/pallup-study-improving-home-based-palliative-care-older-peopleBraun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77–101.