Trial highlights need for improved end-of-life care services in aged care

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There is no ‘one-size-fits-all’ approach to implementing the palliative care model. [Source: Shutterstock]

Flinders University palliative care experts have called for more focus to be placed on preparing aged care staff and family members based on results from their new pilot project.

The ‘Comprehensive Palliative Care in Aged Care Measure’ pilot project saw seven Eldercare metropolitan residential aged care homes and 15 publically funded homes in regional South Australia adopt the model of palliative care at each site.

The model rollout included the palliative care Needs Rounds, or regular staff triage meetings, workforce education and training, specialist palliative care in-reach support and grief and bereavement support for families. 

The Commonwealth initiative was aimed to improve access to quality palliative and end-of-life care for older people living in residential aged care, a call advocates have been making for years.  

Professor Jennifer Tieman and Doctor Sara Javanparast from Flinders University’s Research Centre for Palliative Care, Death and Dying (RePADD) were invited by SA Health to evaluate the project.  

They said their evaluation work has provided great insights and learnings about palliative care initiatives in an aged care setting and that any new initiative requires strong engagement from the sector to “make it work”.  

“We know that aged care is a complex setting facing many challenges including workforce shortage,” Dr Javanparast said. 

The experts said there is no ‘one-size-fits-all’ model which was demonstrated in the pilot by facilities operating at their own organisational capacity with their own infrastructure, geography and access to financial and human resources.  

For example, while participants found the palliative care model is “very positive”, each facility adopted a slightly different version to meet their needs.  

Professor Tieman acknowledged the finding from the Royal Commission into Aged Care Quality and Safety which showed our aged care sector is suffering from an “under-educated and under-skilled workforce in palliative care”. 

“Our evaluation has shown the importance and effectiveness of palliative care training and mentoring to improve identification and management of palliative care needs,” she said.  

“Staff shared how much they appreciated the education sessions and saw palliative care as an area of nursing that needs to be done well. Due to high turnover of workforce in aged care, continued training, refreshing courses and on the job mentoring are critical.” 

Professor Tieman added there is a significant knowledge gap among workers in communicating with residents and families about end-of-life, death, loss and grief. 

The RePADD review emphasised that equitable access to specialist palliative care expertise, like nurses and medical practitioners, is critical.  

“This, indeed, requires broader policy commitment and investment,” stressed Professor Tieman.

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