Aged care services are crucial during palliative care as they ensure comfort, dignity, and quality of life for older people, all while offering support to their families during a challenging time.
Unfortunately, an increasing number of hospitalisations for people receiving palliative care means they may not be receiving the kind of care they wanted, nor in the location of their choice. As Australia’s population ages, it’s expected that amount of people in palliative care will double by 2050, placing even more importance on the education and skills of aged care staff.
Camilla Rowland, Chief Executive Officer of Palliative Care Australia, said aged care must plan now to ensure older people can see out their final days in their own homes, which includes residential care settings,
“Older people don’t want to be shipped off to the hospital every time they become symptomatic. They would like somebody to be trained in their aged care facility that can attend to their needs,” Ms Rowland told HelloCare.
“We know in the aged care sector there are aged care providers embracing palliative care, training their staff and ensuring they have systems in place to support somebody in the last few months of life.”
“The Department of Health and Aged Care has invested strongly in programs like ELDAC (End of Life Directions for Aged Care). What they’re trying to do is embed palliative care practice in aged care facilities. The challenge is that of the 2800 aged care facilities in Australia, only about 110 have this embedded in their care practice.”
From a quality care perspective, there are several ways for aged care staff to upskill themselves in the area of palliative care, building on the introductory training offered in aged care certificates and diplomas. So it’s possible to increase your education even if there is no additional training in your workplace.
Programs such as ELDAC and PEPA (Program of Experience in the Palliative Care Approach) are on offer to all staff, including care workers and nurses. Meanwhile, Ms Rowland provided other impactful tips to help aged care staff better understand how they can support a palliative care recipient.
“I often use the analogy that you don’t expect someone to come into this world without support, why would you expect someone to leave this world without support? It’s not something people can do on their own and it requires an additional area of education and support to understand that you’re doing it the right way,” she added.
With a growing number of palliative care residents, Ms Rowland said everyone should receive a palliative care assessment upon entry if they have a life-limiting illness. Home care service providers should also offer a similar assessment to help plan for evolving needs.
“Palliative care comes in and out of somebody’s journey as needed. It’s not necessarily there every day, all the time. But if someone changes in terms of the stages of their illness they might need symptom control, pain management or support for carers and family.”
Sometimes simple things can make a difference. For example, Ms Rowland suggested placing a sign or symbol on a resident’s door to notify all staff that the person is now receiving palliative care.
She also said ensuring the bedroom feels homely and comfortable is crucial so friends and family can visit for long periods. This includes providing comfortable seating or having the right equipment on hand to support end-of-life care in a residential care setting.
Being responsive is arguably the most important step in preventing residents from needing hospitalisation. So keep a close eye on any subtle changes, whether it’s a resident or client no longer getting out of bed or going to the bathroom on their own. You must then cater to and support those changes.
“I saw a case recently where somebody could no longer swallow properly but different members of the aged care team kept bringing in food that was not appropriate and asking ‘Would you like to eat this?’ rather than understanding that the person was having swallowing difficulties,” Ms Rowland said.
“Therefore, think about what other options you can offer, such as soft foods, liquids or maybe that person doesn’t want to eat at all.”
Building strong relationships with experts
Providing palliative care services can be challenging when resources are limited. Building strong relationships with local palliative care specialists and healthcare professionals can truly help. Ms Rowland said they’re working to ensure General Practitioners (GPs) are skilled in palliative care.
“My mum passed away recently in a care facility where the aged care staff were not really trained in palliative care but the GP looking after her had advanced skills in palliative care. He worked with the aged care team and the visiting local palliative care team to ensure my mother had good end-of-life care,” she said.
Palliative Care Australia also has a directory of palliative care providers and beneficial resources for staff and providers seeking additional information.