End of life care of patients with Glioblastoma multiforme (GBM) – Exploring barriers to discharge planning in an acute setting.

Abstract

Introduction / Background: GBM is the most common type of primary malignant brain tumour in adults. It is a fast growing, aggressive type of tumour commonly associated with poor prognosis. Patients with a GBM experience an array of complications with disease progression, often leading to a number of hospital admissions. A patient’s loss of functional independence can occur suddenly, and the decision for palliative treatment can be overwhelming to family and caregivers. Occupational therapists play a crucial role in guiding the discharge process from an acute setting. There are often many challenges associated with this complex patient group, and these were explored and evaluated within this reflective piece. Method A review of current practice from admission to discharge over a 6month period was conducted through reflection within our acute hospital. Major challenges that affected occupational therapy intervention were identified. Results Our key barriers and considerations when discharge planning from an acute setting were; • Financial burden of equipment and ongoing carer support. • Carer training and the emotional adjustment for family members. • Poor prognosis - pressures of limited time for discharge planning. • Private health model - minimal financial support from health funds on discharge. • Young demographic with limited accommodation options. Identifying these barriers early and delivering timely intervention enables the patient and family to fulfil their final wishes. Conclusion Occupational therapy plays a pivotal role in discharge planning from an acute setting for GBM patients. Utilising an adaptable and flexible approach enables us to deliver an efficient and effective service.