Home care evolution in alberta: how have palliative clients fared?

This study compared palliative and non-palliative home care clients, services and providers, and described changes over a decade of health system reform (1991/92-2000/01). Complete individual-anonymous data from Alberta's home care database were analyzed. Over these 10 years, 7.0% of all home care clients were classified as palliative. The proportion of home care clients who were classified as palliative varied from 2.2% to 9.6% among health regions. The number of palliative clients more than doubled, although this growth was less than that of short-term clients. Home support aides were the most common home care provider, and personal care was the most common service provided to all clients. Although the average number of care hours prior to death for palliative clients increased from 40.9 to 87.9 hours, the relatively small amount of home care provided to dying persons raises concerns about informal caregiver burden and possible overreliance on hospitals to provide end-of-life care.