# Profiles of palliative day care programs in Canada and the United Kingdom: A meta-synthesis

## TL;DR

This study compares palliative day care programs in Canada and the UK to see which features have stayed the same and which have changed over 50 years.

## Contribution

The study identifies enduring and evolving aspects of palliative day care programs through a cross-national thematic meta-synthesis.

## Key findings

- Core elements like administrative structure, palliative care philosophy, and multidisciplinary teams have remained consistent.
- Patient characteristics, care models, and institutionalization have evolved over time.
- Pressure to demonstrate value for funding may threaten the unique social values of these programs.

## Abstract

The first palliative day care program (PDCP) marks its 50th anniversary.

This study examined the distinctive features of PDCPs that have endured, as well as the changes they have undergone in the United Kingdom and Canada, to identify avenues for the development of these programs.

Using primary data from two qualitative studies, conducted in the United Kingdom and Canada, a thematic meta-synthesis was carried out using the expansive secondary analysis approach to identify similarities and distinctions between the PDCPs identified in the two original studies.

The results were drawn from group and individual interviews with 19 participants in Canada, including 13 professionals and 6 managers across 6 PDCPs, and 35 participants in the United Kingdom, including 16 professionals and 18 managers from 3 PDCPs. The results indicate that the administrative structure of the PDCPs, the adoption of a palliative care philosophy, and the multidisciplinary nature of the professional and volunteer teams are the components of the programs that have endured. However, patient characteristics, care models, and institutionalization are constantly evolving.

As PDCPs continuously innovate to adapt to the needs of their patients, the evolution of their components is desirable. However, pressure to demonstrate the relevance of their services to justify financial resources could, while ensuring their sustainability, deprive them of the values and practices that are their most valuable asset and purpose: supporting people living with advanced diseases with palliative care while still remaining in their own homes.

Palliative day care programs in Canada and the United Kingdom

Palliative Day Care Programs (PDCPs) offer people with advanced illnesses a place to receive medical, social, and emotional support while continuing to live at home. Fifty years after the first PDCP opened, this study examined which features of these programs have remained the same and which have changed, through an international comparison of four PDCPs in the United Kingdom and five in Canada. Using secondary analysis of 54 interviews with managers and professionals, we found that core elements—such as administrative structure, palliative care philosophy, and multidisciplinary teams—have endured over time. However, the populations served, models of care, and degree of institutionalization continue to evolve. While adapting to patients’ changing needs is essential, increasing pressure to demonstrate value for funding could unintentionally undermine the social and community values that make PDCPs unique, and that help people live meaningfully at home despite advanced illness.