A Person-Centred Approach to Palliative Care in Aged Care

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A Person-Centred Approach to Palliative Care in Aged Care

PCAs Palli8 plan recommends that aged care embrace a more person-centred and holistic view of palliative care, in particular, care that:

  • Is person and family-centred care provided for a person with an active, progressive, advanced disease, who has little or no prospect of a cure and who is expected to die, and for whom the primary goal is to optimise the quality of life;
  • Is not limited to a diagnosis of cancer, but is also provided for anyone with a life-limiting illness including other chronic conditions, dementia, and non-malignant degenerative diseases;
  • Helps people live their life as fully and as comfortably as possible, ranging from palliative care when their needs are straightforward and predictable to specialist palliative care when there are complex and persistent needs;
  • Accepts that an illness has an impact on the individual and the family unit which requires effective communication, support or shared-decision making and respect for a person's autonomy; and
  • Aligns with the World Health Organisation (WHO) Definition of Palliative Care.

WHO Palliative Care Definition

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual

Palliative care is often erroneously associated only with dying and the very ‘end of life’. This is particularly true within aged care, which leads to palliative care within the last days or weeks of life.  For example:

  • Currently, the Aged Care Funding Instrument (ACFI) is the instrument used to determine levels of funding in residential aged care. The ACFI only funds ‘palliative care’ at the ‘end of life’ where the definition of end of life is referenced as the ‘last week or days of life’. This only enables providers to claim for:

‘Palliative care program involving End of Life care where ongoing care will involve very intensive clinical nursing and/ or complex pain management in the residential care setting.’ [1]

  • The Aged Care Quality Standards, which provide a legislative base for minimum requirements in aged care, do not include a standard or any requirements that refer to palliative care. [2] The Standards include only two references to ‘end of life’, with Standard two focusing on end of life planning and Standard three on meeting the needs, goals and preferences of consumers nearing the end of life.

Expanding the definition and delivery of palliative care in aged care will ensure that all older Australians receive high-quality palliative care when they need it and where they need it.

The need for a person-centred approach to palliative care in aged care underpins many of the other points in the Palli8 plan including the need for a palliative care aged care quality standard, palliative care training for every health and aged care worker, better data collection and increased palliative care funding.

PCA has previously recommended the need for a person-centred approach to palliative care in aged care in submissions to the Royal Commission into Aged Care Quality and Safety:

[1] Australian Government Department of Health (2016) Aged Care Funding Instrument User Guide, accessed at: https://www.health.gov.au/resources/publications/aged-care-funding-instrument-acfi-user-guide

[2] Aged Care Quality and Safety Commission (2019) Guidance and Resources for Providers to support the Aged Care Quality Standards, accessed at: https://www.agedcarequality.gov.au/media/80036

Media release: Palliative care must become core business in aged care