Managers' experiences of providing end-of-life care under the Home Care Package Program

Objective: The study explored the experiences of Australian aged care providers in supporting clients on a home care package to die at home. Methods: Semistructured interviews were conducted with 13 aged care managers responsible for delivering services under the Home Care Package Program. Interviews were analysed thematically. Results: Four themes emerged that illuminated managers' experiences: struggling to meet a preference to die at home; lack of opportunities to build workforce capacity in end-of-life care; challenges in negotiating fragmented funding arrangements between health and aged care providers; and mixed success in collaborating across sectors. Conclusions: Aged care providers want to support older Australians who prefer to stay at home at the end of life. However, most clients are admitted to a residential facility when their care needs exceed a home care budget long before a specialist palliative care team will intervene. Budgets for health and aged care providers must be sufficient and flexible to support timely access to end-of-life care, to reward collaboration across sectors and to invest in building palliative care skills in the nursing and personal care workforce.