palliAGED News

palliAGED turns two

palliAGED is celebrating our second anniversary of supporting the aged care sector with practical evidence based guidance in palliative care. The team celebrated the event with a morning tea and the release of our latest In Focus article palliAGED: Quality Guidance for Quality Palliative Care in Aged Care. 

Launch of new research centre

National Palliative Care Week 2019

Website Updates

Palliative Perspectives blog for aged care

Latest Evidence

New literature

The profile of nursing home (NH) residents is changing with people entering facilities with higher levels of dependency, advanced frailty and dementia. The deaths of patients are now expected within a shorter time frame with an increasing shift toward palliative orientated care. Family members perception of end of life care is recognised as an important quality indicator however it is rarely included in planning care at the end of life. This literature review aimed to identify what families perceived as the elements of good end of life care and to develop a conceptual model of the key aspect's family carers define as good end of life care. One hundred and ten studies were selected for review from 7 countries. Different methodologies were used including ethnographic, interpretive and qualitative methods. Five key themes were identified: perceptions related to perceived life crisis or triggers, and transitions in care, environmental and human factors, good end of life care and dying in dignity, information, understanding and support and establishing relationships and partnerships with health professionals. The review found most elements of good end of life care identified by family carers shared common ground with palliative care. Family carers wanted care aimed at early identification and treatment of physical, psychological and spiritual issues. The model recommended the palliative approach be adopted at an early stage from the time of recognising physical or social changes. The model also recommended there be adequate staff training in palliative care and policies in place to support patient and family focussed care.

Residential aged care facilities (RACF) are now caring for more complex older patients with the majority taking 5 or more medications. An increase in number of medications can increase the risk of adverse drug reactions particularly when first admitted. This systematic review investigates interventions to improve continuity and management of medications when discharging and transitioning patients from hospital to a RACF. Seven studies were included and all interventions involved a multidisciplinary approach to discharge facilitation. To facilitate continuity of care medications need to be supplied in the correct format, an up to date medication chart needs to be in place and comprehensive and accurate discharge medication information needs to be available. The review found there was a high risk of medication related issues on discharge to a RACF and these were multifaceted. The review found a multidisciplinary approach including a pharmacist was vital to improving continuity of medication management. No approach addressed all barriers to continuity of care. However, it was noted better medication management could be enabled with increased access and use of electronic records.

This comprehensive systematic synthesis examined the available evidence regarding service delivery models that optimise quality of life for people at the end of life. Seventy-two studies were included with all WHO regions represented with studies predominately from the Americas, Europe and the Western Pacific regions. Although globally there was a large number of service delivery models for end of life and palliative care two overarching service delivery models were identified. The ‘Integrative Geriatric Care' and 'Integrated Palliative Care’ models both aimed to maximise people's quality of life at the end of life and advocate comprehensive assessment and person centred. Both approaches highlighted the need to integrate care across the care continuum and to focus service involvement triggered by patient need and the likelihood of benefit. The findings highlighted the need for urgent health system change to improve end of life care as part of universal health coverage and improve the continuum between healthy ageing and healthy dying.

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Sector News

New Charter of Aged Care Rights

The new Charter of Aged Care Rights has now been released and will take effect from 1 July 2019.The Charter will replace the existing charters that relate to care recipients' rights and responsibilities for those receiving Government subsidised aged care.

The Charter will provide the same rights to aged care consumers regardless of the type of care they receive and help to create a shared understanding about the rights of people receiving aged care. The Charter has been translated into multiple languages. The Older Persons Advocacy Network (OPAN) is supporting the Department of Health with raising awareness and providing education about the Charter, which includes support to aged care service providers and consumers. More information is available on the OPAN website.
 

New Aged Care Quality Standards resources

The Aged Care Quality and Safety Commission has released two new videos aimed at helping people receiving and providing aged care services to understand the new Aged Care Quality Standards. There is a video for consumers about the standards called What the new Aged Care Quality Standards mean for you. The aged care service provider educational video has been produced to support aged care services as they prepare for the new aged care Quality Standards coming into effect from 1 July.
 

The Royal Commission into Aged Care Quality and Safety

The Royal Commission into Aged Care Quality and Safety has released new background papers to inform their work. The second paper in this series ‘Medium- and long-term pressures on the system: the changing demographics and dynamics of aged care’ explores complex issues associated with the country’s changing demographic profile, including changes in patterns of disease and dependency, the rising incidence of dementia, changing expectations and the changing cultural profile of the Australian community. It also explores current arrangements, future pressures and a greater need for preventative and restorative health. The third paper ‘Dementia in Australia: nature, prevalence and care’ provides a high-level introduction to dementia. The paper reviews the findings of broad-reaching Australian and international research, demographic reports and literature, and addresses a number of key issues. The fourth paper ‘Restrictive practices in residential aged care in Australia’ paper notes that restrictive practices can elicit concern for a number of reasons because fundamentally, they impact on the liberty and dignity of the care recipient and without consent, their use may infringe on an elderly person’s legal rights. The papers are available for download on the Commission’s website.

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