Potential barriers to end-of-life care provision by paramedics in the community

Background: Patients and families are increasingly relying on ambulance services in caring for palliative and end-of-life patients owing to the ageing population, limited advanced care planning and insufficient palliative care services in the community. Methods: The authors reviewed existing literature regarding symptom control, communication and discharge planning, advanced care planning, and education. Findings: Research is limited regarding paramedic involvement in end-of-life care. Many paramedics require end-of-life care training to manage this cohort of patients. Discharges from the acute sector to the community setting require urgent attention, including the implementation of advanced care plans to guide practice. Conclusion: Paramedics require training in end-of-life care to treat patients effectively. Palliative care services require additional resources, skilled health professionals and adequate funding to manage the increasing number of patients dying at home. Improved referral pathways, including those for hospital discharge, are needed between paramedics and community nursing/palliative care teams to ensure best outcomes for patients. Advanced care planning must be addressed by all health professionals.