The new Aged Care Quality Standards make no reference to palliative care, despite the recent acknowledgements of the importance of palliative care in aged care facility settings.
With around 60,000 Australians dying in aged care facilities every year, it’s absolutely imperative that the facilities can provide the most sensitive, professional, and educated care for older people at the end of their life.
In addition, end-of-life care should extend to cover support for the bereaved, including families and the aged care staff themselves, who often form close bonds with the residents they care for daily, often for many years.
Board Chair of Palliative Care Australia, Dr Jane Fischer, told HelloCare, “Ultimately most people using aged care services are in the last years of their life, and they should be supported to have a high quality of life, right to the end of life.”
However, the new Aged Care Quality Standards, which are due to come into effect on 1 July 2019, don’t mention palliative care, although they do refer to ‘end-of-life care’.
“The newly released Aged Care Standards do not specifically mention palliative care,” Dr Fischer said.
“PCA has consistently called for a specific palliative care standard to be part of the Aged Care Quality Standards”, she said.
In the new standards, end-of-life planning is a requirement of Standard 2 ‘Ongoing assessment and planning with consumers’. The requirement is that ‘assessment and planning identifies and addresses the consumer’s current needs, goals and preferences, including advance care planning and end of life planning if the consumer wishes’.
It is mentioned again in Standard 3 ‘Personal care and clinical care’ with the requirement that ‘the needs, goals and preferences of consumers nearing the end of life are recognised and addressed, their comfort maximised and their dignity preserved’.
These requirement don’t fully encompass the entirety of palliative care, Dr Fischer said.
“PCA has been continuously requesting that the Standards include a specific section dedicated to palliative care issues,” she said.
The importance of providing good palliative care to aged care residents was highlighted in the Federal Budget this year, when Aged Care Minister Ken Wyatt announced that $33 million would be spent on improving palliative care for older Australians living in aged care.
Dr Fischer said the new standards also overlook the need for grief and bereavement support for consumers, carers and aged care staff.
“Upskilling the workforce in this area would not only assist in supporting the families and carers of the person who has died, but also foster an environment of support for other residents and the staff themselves, an important component of self-care and staff retention,” Dr Fischer said.
The 2018 National Palliative Care Standards is a guide for providing high-quality palliative care. It can be applied in all palliative care settings, including aged care.
“The National Palliative Care Standards are an important part of the broader health care quality system, as they promote consistent high-quality care that is safe, respectful and consumer focused,” said Dr Fischer.
While the standards are not compulsory for aged care service providers, they may be applied to inform a service or organisation’s accreditation process.
Dr Fischer said PCA is pleased that end-of-life care has been included in the terms of reference for the Aged Care Royal Commission.
“We need to examine the quality of palliative care provision within aged care services and the capacity of the aged care sector to ensure people receive appropriate referrals and access to specialist palliative care and other support services, including after hours,” she said.
Good article Caroline. There is also no legal recognition in estates for children who sacrifice their income and personal well being to care for an aged parent with Alzheimer dementia in their own homes. This means an individual or family can care for a parent for years, paying all of their daily expenses in their own time, with serious consequences for future financial security for the carer, and in the end they have to take others who have done little or nothing to court to be awarded estate recognition (family act 1972). I have heard terrible stories of people being evicted from family homes due to other family members (who have done little or nothing for years to support their parent) – demanding their share after the parent passes. The carer having kept the parent safe and loved for years. Laws need to be brought in for automatic payment of a lump sum from any estate for an individual or couple who care for a parent – equal to a minimum wage. This would equalize the burden and also encourage people to care for a parent they love knowing they will, in time, not be penalised financially for their efforts.