ideasIdea
Home end-of-life care kits and trained family carers where no hospice exists
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.
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.
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.
What would test it
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
Who has to act
philanthropy
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks
- Pain relief and palliative care are unavailable to most · Most people who die of cancer worldwide do so without adequate pain relief.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.