The roles, responsibilities and practices of healthcare assistants in out-of-hours community palliative care: A systematic scoping review

• Published in: Palliative Medicine Vol. 34; no. 8; pp. 976 - 988
• Main Authors: Fee, Anne, Muldrew, Deborah, Slater, Paul, Payne, Sheila, McIlfatrick, Sonja, McConnell, Tracey, Finlay, Dori-Anne, Hasson, Felicity
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01-09-2020; Sage Publications Ltd
• Subjects: After-Hours Care; Allied Health Personnel; Assistants; Caregivers; Community; Health care; Hospice and Palliative Care Nursing; Humans; Normality; Out of working hours; Palliative Care; Review; Systematic review; Working hours; home care; Healthcare assistant; after-hours; community; adult; palliative care; scoping review
• ISSN: 0269-2163; 1477-030X
• DOI: 10.1177/0269216320929559

Background:
Access to community palliative care ‘out-of-hours’ – defined as care provided after the normal hours of work – is advocated globally. Healthcare assistants, who provide care under the direction of a qualified professional, are increasingly employed to help deliver such care, yet there is a little understanding regarding their role, responsibilities or contribution.
Aim:
The aim of this study was to identify the roles, responsibilities and contributions of healthcare assistants in out-of-hours community palliative care.
Design:
Scoping review
Data sources:
Five bibliographic databases (CINAHL, MEDLINE, EMBASE, PsycINFO and Scopus) and grey literature were searched using a predefined search strategy. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews statement.
Results:
The search yielded six papers using quantitative, qualitative and mixed methods. Results highlighted a lack of recognition of the role and contribution of healthcare assistants. A concurrent theme was that healthcare assistants continually monitored and responded to patient’s and family’s physical and emotional needs; there was also self-reported evidence indicating patient and family benefit, such as maintaining a sense of normality and support to remain at home.
Discussion:
This review highlighted a dearth of evidence relating to the healthcare assistant role in out-of-hours palliative care. Limited evidence suggests they play a role, but that it is hidden and undervalued. Such invisibility will have a significant impact on the planning and delivery of out-of-hours palliative care. Future research is needed on role development for the benefit of patients and caregivers.