# Home end-of-life care kits and trained family carers where no hospice exists

Source: https://onco.cc/ideas/idea-acc-home-based-end-of-life-kits/  
OnCo record `idea-acc-home-based-end-of-life-kits` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Most people in poorer countries die at home without any professional support. A simple kit of medicines and supplies plus a few hours of training for a family member could make dying far less painful.

## Summary

Where community palliative services do not exist, families care for the dying with no medicines or guidance. A standardised home kit (oral morphine, anti-emetics, laxatives, wound and pressure-care supplies, an illustrated guide) issued at discharge with brief carer training and a phone line has been piloted in several African settings. Defining the kit, training, and supply chain, and evaluating it rigorously, could produce a scalable minimum standard.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Families receiving a kit and training will report significantly lower patient pain and distress in the last weeks of life and fewer emergency hospital visits than families receiving standard discharge.
- Rationale: Family caregivers already provide most end-of-life care; equipping and training them is the only feasible model at scale in many settings.
- Proposed test: A cluster-randomised trial across 20 hospitals discharging patients with advanced cancer, with carer-reported pain and distress and unplanned readmission as endpoints.
- Maturity: early-clinical
- Actor: philanthropy

## Sources

- Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care: https://www.who.int/news-room/fact-sheets/detail/palliative-care

## Connected records

- ideas: [Locally prepared oral morphine solution, licensed for nurse prescribing](https://onco.cc/ideas/idea-acc-local-oral-morphine-production/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Pain relief and palliative care are unavailable to most](https://onco.cc/bottlenecks/b-palliative/)

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