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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 your Resident Agreement from your aged care facility.

Royal Commission into Aged Care Quality and Safety

The Royal Commission into Aged Care Quality and Safety was established on 8 October 2018, with The Honourable Richard Tracey AM RFD QC and Ms Lynelle Briggs AO appointed as Royal Commissioners. The Honourable Tony Pagone QC has recently been appointed as a Commissioner taking over as Chair of the Royal Commission following the death of Commissioner Tracey.

The Letters Patent for the Royal Commission, which formally appoint the Royal Commissioners, also outline the Commission’s Terms of Reference

The Royal Commission was recently granted an extension of six months. The Commissioners were required to provide an interim report by 31 October 2019. A copy of the Interim Report: Neglect can be Royal Commission into Aged Care Quality and Safety. The Commissioners are required to provide a final report by 12 November 2020.

The Royal Commission will continue to accept submissions until the end of April 2020.

Transcripts of all hearings are available on the Commission’s website.  All hearings are also broadcast and can be watched live or viewed afterwards.

Background papers

The Royal Commission has published the following background papers (which can also be accessed from the publications page of Commission’s website):

Research Paper 1: How Australian residential aged care staffing levels compare with international and national benchmarks – prepared by Australian Health Services Research Institute at the University of Wollongong

Background Paper 8: Background Paper 8: A History of Aged Care Reviews

Background Paper 7: Legislative Framework for Aged Care Quality and Safety Regulation

Background Paper 6 – Carers of older Australians

Background  Paper 5 – Advance care planning in Australia

Background Paper 4 – Restrictive practices in residential aged care in Australia

Background Paper 3 – Dementia in Australia: nature, prevalence and care

Background Paper 2 – Medium- and long-term pressures on the system: the changing demographics and dynamics of aged care

Background Paper 1 – Navigating the maze: an overview of Australia’s current aged care system

Quality and Safety Regulation

Research Paper 1: How Australian residential aged care staffing levels compare with international and national benchmarks – prepared by Australian Health Services Research Institute at the University of Wollongong

Palliative care at the Royal Commission

The importance of palliative care has been recognised by the Royal Commission with the issue canvassed in hearings held in Perth between 24 – 28 June 2019. 

Palliative Care Australia’s Board Chair Dr Jane Fischer represented the organisation 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.

Palliative Care Australia had previously provided the Royal Commission with an Issues Overview, which highlighted a number of structural and policy-based issues that contribute to the lack of understanding and attention given to palliative care in aged care, including:

  • ‘Palliative care’ should inform structures and policy not just ‘end of life care’
  • The Aged Care Quality Standards do not include the provision of palliative care as an outcome for consumers or requirement for providers
  • Commonwealth Home Support Program (CHSP) and Home Care Packages (HCP) ‘versus’ palliative care – impact on the choice to stay at home
  • Palliative care is not appropriately recognised for funding in residential care
  • The aged care workforce needs support to make palliative care core business.

PCA Submission to the Royal Commission into Aged Care Quality and Safety_October 2019

PCA Media Release: Palliative care must be considered ‘core business’ in aged care

Perth Hearing Full Transcript Thursday 27 June 2019

Royal Commission Witness Statement – Dr Jane Fischer

Perth Hearing: Palliative Care – Common Ground Propositions

Palliative care in aged care_Royal Commission Issues Overview_May 2019

End of Life Directions for Aged Care (ELDAC)

End of Life Directions for Aged Care (ELDAC)

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.

Policy Statements

Palliative Care and Dementia 

Spiritual Care: Integral to Palliative Care in Aged Care

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.

2017 National Award for Excellence in Palliative Care in an Aged Care Setting

Peter Jenkin was awarded the Palliative Care Australia National Award for Excellence in Palliative Care – in an Aged Care Setting in 2017. Discover what makes his work at Resthaven in South Australia so special.

Resources

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.

Dementia Australia
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.

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