Aged Care

Comprehensive measures to improve palliative care in residential aged care

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A pilot project conducted in South Australia has shed light on the urgent need for comprehensive and appropriate measures to enhance palliative care in residential aged care settings.

Experts in palliative care from Flinders University are calling for increased focus on preparing aged care staff and family members based on the successful outcomes of this innovative initiative. The project, known as the “Comprehensive Palliative Care in Aged Care Measure,” was implemented as a Commonwealth initiative to improve access to quality palliative and end-of-life care for older Australians residing in residential aged care.

It was implemented in seven not-for-profit Eldercare aged care facilities in metropolitan Adelaide and 15 publicly funded residential aged care homes in regional South Australia.

Each site adopted various models of palliative care, including palliative care Needs Rounds, workforce education and training, a traineeship model, specialist palliative care in-reach support and grief and bereavement support for families.

Dr Sara Javanparast, Senior Research Fellow at the Research Centre for Palliative Care, Death, and Dying (RePADD) at Flinders University, along with Professor Jennifer Tieman, were invited by SA Health to evaluate the project.

Their evaluation work has provided valuable insights and learnings about palliative care initiatives in aged care settings. They emphasise that any new initiative requires active engagement from the sector to ensure its success.

“We know that aged care is a complex setting facing many challenges including workforce shortage,” Dr Javanparast said. “Any new initiative requires strong engagement with the sector to ensure they are aware of the value that the project add to them, their facilities and to residents.”

The evaluation also highlighted the fact that there is no one-size-fits-all model for palliative care in aged care. Each site in the trial adapted the model to meet its specific organisational capacity, infrastructure, geography, and available financial and human resources.

While participants found the palliative care model to be positive, respectful and beneficial, each site implemented a slightly different version to cater to their unique needs.

The evaluation further revealed the critical importance of palliative care training and mentoring in improving the identification and management of palliative care needs.

The under-educated and under-skilled workforce in palliative care, as highlighted by the Royal Commission into Aged Care Quality and Safety, calls for ongoing training, refreshing courses, and on-the-job mentoring due to the high turnover of staff in aged care.

Professor Tieman emphasises that there is a significant knowledge gap in effectively communicating with residents and families about end-of-life matters, death, loss and grief.

While the pilot project was limited to a small number of metropolitan and regional aged care facilities, the RePADD review emphasises the need for equitable access to specialist palliative care expertise, including nurses and medical practitioners, to ensure all Australians in residential aged care receive high-quality palliative care.

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