3 minute read
Assistive technology in palliative care
Renae Kelly, Bridget Manning and Dr Kieran Broome, Medical Aids Subsidy Scheme clinical team members, Queensland
The Medical Aids Subsidy Scheme (MASS), a statewide funding body for assistive equipment in Queensland, historically did not subsidise aids and equipment for people receiving palliative care. This changed on 1 April 2020, when MASS launched the Palliative Care Equipment Program (PCEP). The program provides assistive devices to children and adults in their final six months of life (with a possible extension up to 12 months) with no co-payment. The assistive equipment comprises basic, off-the-shelf mobility aids, daily living aids, home oxygen equipment and continence aids. In most cases, equipment is provided to clients within one to two business days. Clinical eligibility utilises the Australia-modified Karnofsky Performance Status (AKPS) and Resource Utilisation Group – Activities Daily Living (RUG-ADL) scores, as recommended by the Palliative Aged Care Outcomes Program. These tools measure functional status and can be useful for prognostication.
Prior to the PCEP, provision of assistive equipment to people with life-limiting conditions was fragmented and inequitable across the state. To our knowledge, MASS PCEP is one of the first government funded programs of its kind.
Two years on, data analysis and feedback indicate that MASS PCEP has achieved its central aim – the equitable and coordinated provision of assistive equipment to people with life-limiting illnesses across the entire state. It appears to have a high potential to translate to other jurisdictions.
The program has funded equipment for more than 3,000 people. Most applicants (99.1%) have been adults, with a small number being children (0.9%). The most common medical condition has been cancer, at around 75%. Saliant findings include most program participants having more hospitalfree days, increased independence (where applicable) and reduced carer burden.
Delivery of equipment to remote areas has been a challenge, so storage facilities were established in regional areas to reduce transportation time. Referrals to occupational therapists and palliative care specialists reportedly increased in some regions in relation to the program.
Program participant story
Mr K. had not been able to sit out on his deck for twelve months until he received help through Brisbane community therapists and the MASS Palliative Care Equipment Program. Back on his deck after a long hiatus, Mr K. was able to feel the sunshine on his face and arms, watch and listen to the birds and soak in his bush surroundings.
Living with motor neurone disease, Mr K. had very limited movement of his limbs and was dependent on a ventilator. His occupational therapist, physiotherapist and registered nurse made applications to the program for Mr K. to receive an electric/ adjustable bed, pressure redistribution mattress, wonder sheet, hoist, mobile pressure care chair and continence aids.
The equipment greatly helped family provide care for Mr K. and maintained his wellbeing. For example, prior to receiving the pressure redistribution mattress through the MASS PCEP, Mr K. was suffering with pressure injuries on his heels and the base of his spine. The new mattress helped these pressure injuries heal and he did not experience any more.
Once Mr. K. had been hoisted into his mobile pressure care chair, he could be easily manoeuvred through the house. With access to the family room, Mr K could enjoy listening to 1950s music on a highquality sound system – a nice contrast to using a portable CD player in his bedroom. He was also able to celebrate his eldest son’s birthday in their family room. Mr K. experienced immense pleasure having his whole family together at home.
When asked if they could have sourced the equipment without the MASS PCEP, Mrs K. replied, ‘I wouldn’t have known where to start!’
View from Mr K’s deck
About the authors
Renae Kelly (OT), Bridget Manning (SP), and Dr Kieran Broome (OT), form part of the clinical team at the Medical Aids Subsidy Scheme in Queensland.
