Needs and experiences of homecare workers when supporting people to live at home at the end of life: a rapid review

Cat Forward, Zana Bayley, Liz Walker, Justine Krygier, Caroline White, Kasonde Mwaba, Helene Elliott Button, Paul Taylor, Miriam J Johnson

Research output: Contribution to journalReview articlepeer-review


Background Social homecare workers provide essential care to those living at home at the end of life. In the context of a service experiencing difficulties in attracting and retaining staff, we have limited knowledge about the training, support needs and experiences of this group.

Aim To gain a timely understanding from the international literature of the experience, training and support needs of homecare workers providing end-of-life care.

Methods We conducted a rapid review and narrative synthesis using the recommendations of the Cochrane Rapid Reviews Methods Group. Building on a previous review, social homecare worker and end-of-life search terms were used to identify studies. Quality appraisal was conducted using a multimethods tool.

Data sources CINAHL and Medline databases (2011–2023; English language).

Results 19 papers were included representing 2510 participants (91% women) providing new and deeper insights. Four themes were generated: (1) emotional support; homecare workers need to manage complex and distressing situations, navigating their own, their clients’ and clients’ family, emotions; (2) interaction with other social and healthcare workers; homecare workers are isolated from, and undervalued and poorly understood by the wider healthcare team; (3) training and support; recognising the deteriorating client, symptom management, practicalities around death, communications skills and supervision; (4) recognising good practice; examples of good practice exist but data regarding effectiveness or implementation of interventions are scant.

Conclusions Social homecare workers are essential for end-of-life care at home but are inadequately trained, often isolated and underappreciated. Our findings are important for policy-makers addressing this crucial challenge, and service providers in social and healthcare.
Original languageEnglish
Article numberspcare-2023-004737
JournalBMJ Supportive and Palliative Care
Publication statusPublished - 18 Mar 2024


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