Palliative Care in Aged Care
As Australia’s population ages and the number of people using aged care services increases, the demand for palliative care in aged care is also increasing.
It is important that older people are supported to receive high quality palliative care in the setting of their choice, whether that be in their own home, in a residential aged care facility, in an acute care hospital or in a dedicated hospice service.
Ensuring the availability of high quality palliative care in aged care facilities and people’s own homes will enable more older Australians to have a good death, receive better support for their families and carers during the dying and bereavement process, and facilitate improved allocation of scarce health resources.
To find out what palliative care services are available to you or your loved one talk with your GP, your home care service coordinator or consult the care manager at your aged care facility.
Strategy for palliative care in aged care
Palliative Care Australia (PCA) has been engaging with the Royal Commission in to Aged Care Quality and Safety through a range of submissions. These submissions outline a number of recommendations that PCA has distilled to the following eight key points:
- Aged care policy should align with the World Health Organisation definition of palliative care and not be restricted to ‘end of life’ or last days/weeks.
- Palliative care must be included, and clearly articulated, in the Aged Care Quality Standards, which all Commonwealth funded aged care services are required to meet.
- All undergraduate nursing, allied health, medical courses and Certificate courses for care workers must include mandatory units on palliative care.
- Establish National Minimum Data Sets for palliative care which include both health and aged care.
- Funding is needed to fully implement the National Palliative Care Strategy 2018 ensuring aged care is included.
- Investment and the development of innovative models of care are required to ensure older people have equitable access to specialist palliative care.
- Ensure a greater focus on community awareness on death and dying, palliative care and advance care planning.
- Palliative care should be a priority of the National Federal Reform Council, National Cabinet and the Health Council, supported by the appointment of a National Palliative Care Commissioner (PCA has previously called for palliative care to be a COAG priority).
All PCA submissions to the Royal Commission are available at: Submissions and Reports.
PCA’s new Palli8 plan proposes eight key recommendations to improve palliative care in aged care, with calls for much needed funding to fully implement the National Palliative Care Strategy 2018, together with palliative care training for every health and aged care worker.
Royal Commission into Aged Care Quality and Safety
The Royal Commission was established on 8 October 2018 and is currently overseen by Commissioners Ms Lynelle Briggs AO and the Honourable Tony Pagone QG.
The Letters Patent for the Royal Commission, which formally appoint the Royal Commissioners, also outline the Commission’s Terms of Reference.
The Commissioners provided an interim report on 31 October 2019. A copy of the Interim Report can be found at: Royal Commission Interim Report. The Commissioners are required to provide a final report by 12 November 2020. The Royal Commission has also published the a range of background papers , research papers and consultation papers available here.
Palliative care at the Royal Commission
The importance of palliative care has been recognised by the Royal Commission with palliative care specifically canvassed in hearings held in Perth between 24 – 28 June 2019.
Palliative Care Australia’s previous Board Chair Dr Jane Fischer represented the PCA as a witness before the Royal Commission, appearing as part of a palliative care expert panel on Thursday 27 June 2019. Dr Fischer provided a detailed witness statement and agreed to a set of Common Ground Propositions outlining areas of agreement with the other experts that appeared on the same panel. This included that palliative care cannot and should not be considered an optional extra within the aged care system. It needs to be an integral part (core business) of any aged care service.
End of Life Directions for Aged Care (ELDAC) is a national specialist palliative care and advance care planning advisory service. This service comprises a comprehensive website and a telephone advisory service. These resources will equip care providers with skills and information to help older Australians receive high-quality end of life care in familiar surroundings with little or no need for hospitalisation.
ELDAC uses innovative technology solutions to assist those who work in aged care and palliative care. The tools will provide access to information and resources including toolkits for those who provide residential aged care, home care and primary care. A telephone and web-based navigation service will help aged care workers, nurses and GPs to find information about end of life care and relevant local or regional services.
The policy component of the ELDAC Project prepares policy briefs which include synthesised information to inform decision-makers about key policy and planning issues in palliative care and advance care planning in aged care. PCA co-leads this work with Leading Age Services Australia (LASA), Aged & Community Services Australia (ACSA) and Catholic Health Australia (CHA) in partnership with Australian Hospitals and Healthcare Associations (AHHA) and Australian Centre for Health Law Research (ACHLR) at Queensland University of Technology (QUT).
Palliative Care and Dementia: a joint policy statement from PCA and Dementia Australia
Spiritual Care: Integral to Palliative Care in Aged Care: a joint position statement from PCA and Meaningful Ageing Australia
Excellence in palliative care in residential aged care video series
Palliative Care Nurse Practitioners based at Calvary’s Clare Holland House have developed an in-reach model with Canberra residential aged care facilities to deliver palliative care needs rounds and case conferences. The INSPIRED team won the team excellence award in the 2019 HESTA Australian Nursing and Midwifery Awards. Nurse Practitioner Nikki Johnston OAM won the 2019 inaugural federal Health Minister’s Award for Nursing Trailblazers.
This video explains the work they do alongside residential aged care staff to ensure that palliative care is delivered to residents who would benefit from it – featuring staff and residents from Calvary Haydon Retirement Community.
10 questions to ask about palliative care in residential aged care
We recommend you or your family ask the following questions to find out whether the aged care service can manage your changing needs in the final stage of your life.
Department of Health
Provides information, tools and resources to support the aged care sector through evidence-based policy, well targeted programs, and best practice regulation.
My Aged Care
Information for older people, their families, and carers on ageing and aged care, and a pathway for needs assessment and access to support services
palliAGED by CareSearch provides free online evidence-based information, practice guidance and resources on end of life and palliative care for aged care. This includes the palliAGED Apps, which provide health professionals with easy to access to palliative care information at the point of care.
Provides advocacy, support services, education and information for people of all ages, living with all forms of dementia, their families and carers.
Older Persons Advocacy Network (OPAN)
Provides advocacy, information and education services to older people to address issues related to Commonwealth funded aged care services.