Background: Providing palliative care for individuals who use alcohol and/or drugs poses a multi-faceted challenge. In addition to clinical and social issues, individuals may endure mental health problems, co-morbidities and homelessness. There are few models of care to support them and their carers.
Aim: To identify the palliative care needs and models of care for people who use drugs and/or alcohol.
Design: A mixed-methods systematic review of the literature was conducted.
Data Sources: Six databases were searched to identify relevant studies, cumulating in thirteen studies being included, which used a range of data collection methods, across various settings. Qualitative and quantitative data were tabulated together using narrative synthesis, then categorised according to outcomes of interest, with similar and divergent findings reported accordingly.
Discussion: The difficulties for individuals who use alcohol and/or drugs, as well as their formal and informal carers, in relation to end-of-life care were examined, revealing issues to do with access, care and skills. Three themes emerged which could underpin the development of a model of care: interpersonal/organisational relationships; holistic care; and interactions with other services and training.
Conclusion: Being sensitive to individual needs is important when caring for an individual who uses drugs and/or alcohol. Despite end-of-life needs of this population being different to others, challenges include creating inclusive organisational policies, sensitising staff to distinctive individual needs and training exchanges for staff working in both drug and alcohol services and palliative care. And working collaboratively with specialised drug and/or alcohol services to meet holistic needs is vital.