palliAGED Updates

Intimacy and Sexuality

palliAGED conference activity

Australian Context

Engagement Project news

• Article published in the newsletter (June 2019), Australian Counselling Association (ACA): How palliAGED can help counsellors with end of life for older Australians
• Article published in InMotion magazine (June 2019), Australian Physiotherapy Association: Create a safe space for open discussions
• Article published in Connections magazine (June 2019), Occupational Therapy Australia: Finding evidence and clinical guidance you can trust and why it matters (205kb pdf)

Palliative Perspectives blog for aged care

Latest Evidence

New literature

Currently under-recognised, frailty is expected to increasingly be  part of the profile of people receiving palliative care. Frail older people often experience poor health, falls, fractures, disability and loss of independence. The objective of this review was to understand how advance care planning (ACP) can be better implemented for frail older people and for all relevant multidisciplinary professionals. Forty-two studies were included of which one was conducted in Australia. Although the title specifies older people living in the community, of the included studies ten focussed on the views of older people and their families, the remainder focussed on the needs and experiences of professionals. The findings show that frail older people are most likely to engage with ACP if it is introduced in routine care through multiple opportunities over time and across systems of care. ACP is successful if it is relevant to their current care as well as planning future care. This is the first proposal for a model that illustrates the relationships between the frail older person, the family and the health professionals and the factors that optimise ACP. Those factors include living well now, recognising triggers of decline, discussing death and dying, and the need for professionals to develop their skills and competencies in ACP so that they recognise and proactively use and create ACP facilitation opportunities in the care of frail older people. Key implications for practice include the need for frail older people to engage early with ACP and the importance of reframing ACP as something that in addition to future planning also promotes living well now.

Mealtimes are often as important as a way of coming together and interacting as they are for us maintaining our health through good nutrition. For people living with dementia, loss of appetite and memory, and problems with the functional ability to eat can cause difficulties with eating and nutrition. For people with dementia, losing weight and/or malnutrition are significant concerns. The objective of this review was to report on the effectiveness of interventions designed to improve mealtime function for residents living with dementia. The 20 studies included in this review were all conducted outside of Australia. The approaches investigated included the influence of food presentation, the physical environment, skills training for people with dementia and two therapies: music and the presence of animals. Findings were limited due to the small scale and lack of rigour in study design or reporting, and strong guidance for specific approaches could not be made. However, it was found that some low-cost and easy-to-implement interventions such as music therapy, creating a homelike dining area, the use of high-contrast crockery and red-coloured cups, the presence of fish tanks in a dining room appear to increase food and fluid intake. Programs designed to improve dexterity, coordination and memory showed mixed results in improving these skills with some improvements in oral intake. While further research is required to establish effectiveness, this review provides insights into low cost and easily implemented approaches that might be applied to encourage increased food intake by people with dementia in the residential aged care setting.

Even in the late stage of cognitive impairment, people with dementia (PWD) are still able to remember and enjoy music. Music and/or its elements (sound, rhythm, melody and harmony) are increasingly being used to meet physical, emotional, mental, social and cognitive needs of PWDs with promising results. This study reviewed randomised control trials (RCTs) to better understand the effects of individualised music listening interventions on PWDs. The reviewers focussed on the impact of intervention on the behavioural and psychological symptoms of dementia (BPSDs) including agitation, anxiety and depression, cognitive function, physiological outcomes and quality of life. The four included studies were conducted in Canada, Italy, Japan and Spain, and severity of cognitive impairment ranged from mild to very severe. Individualised music lists were created with input from the PWD and/or their family members and/or carers. These listening interventions had positive short-term effects on mood and emotion. Short-term improvements were also noted in behavioural and psychological symptoms of dementia (BPSDs) such as verbally agitated behaviour, non-aggressive behaviours, delusion, disinhibition, anxiety, phobias, affective disturbance and depression. However, as three of the four studies had less than 50 participants, and the participants were living with different degrees of dementia, it is difficult to draw firm conclusions from this review. A positive effect on cognitive function and dementia severity was not found. Although greater benefits were noted with other more intensive and/or costly music therapy interventions for some outcomes, the ease of administering individualised music lists is an important consideration. Further research is needed to strengthen the evidence base and to determine at which stage of dementia severity the greatest benefit might be gained.

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New My Age Care website launched

The Charter of Aged Care Rights Resources 

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