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Don’t put off palliative care until ‘last minute’, aged care warned

Residential aged care facilities should recognise the need for palliative care much earlier to avoid hospital admissions at end of life.

That’s according to Jane Newbound, aged care project manager at North West Metropolitan Region Palliative Care Consortium.

Based at Melbourne City Mission, Ms Newbound works with 170 aged care facilities to improve the palliative care they provide to 12,000 residents.

Jane Newbound

“Palliative care in aged care is their core business and staff need to be trained and upskilled to provide consistency in care across shifts,” she says.

Ms Newbound’s group helps to improve education in end-of-life care and procedures, including reviewing services and conducting workshops to better identify residents who are deteriorating.

“We also work with hospital in-reach teams to improve acute assessments with emergency department teams and senior aged care staff, to avoid hospital admission from aged care,” she said.

People go into aged care to die

Ms Newbound said that new admissions to aged care are increasingly people with life-limiting illness coming from the acute sector, many classed as ‘”respite.”

People are also staying longer at home longer due to the increasing government support for community aged care, she said.

“When they enter aged care they are older, have greater cognitive decline and more complex medical history, with many needing end of life and high care,” she said.

She argues this has not been addressed by the Federal Government’s definition of palliative care under Aged Care Funding Instrument guidelines which is restricted to “terminal care.”

“The government is not looking at the numbers. It doesn’t pay facilities for effective, anticipatory palliative care until end of life is imminent.”

By comparison, Ms Newbound points to Victorian Government funding for eight regional aged care projects, including her own, to strengthen the capacity of aged care services to provide palliative and end-of-life care.

Implications for aged care

Aged care environments need to be designed for providing mainly end-of-life care – with quiet rooms, places for families to stay and a layout that ensures coffins can leave in a dignified manner, Ms Newbound said.

“The emphasis on building new facilities that look like hotels seem to be more for the children of potential residents,” she said.

“Colours and designs should suit people with cognitive impairment.”

Ms Newbound recommends a whole-of-facility approach where it is the responsibility of all staff – nurses, carers, leisure and lifestyle staff, cleaners and hospitality – to work together to provide good palliative and end-of-life care.

National Palliative Care Week runs 21-28 May and this year focuses on aged care. 

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3 Responses to Don’t put off palliative care until ‘last minute’, aged care warned

  1. Ottie Oswald May 27, 2017 at 12:54 pm #

    Couldn’t agree more. Let us not forget the people we nurse and their requirements heading towards an ultimate death. We can do all the environmental alterations WE think will be beneficial but the ultimate requirement is sensitive and thoughtful palliative care. Amen.

  2. Philip Millefolie June 4, 2017 at 10:10 am #

    I am in Pallative care at home because I share my home with a caring bachelor son. Besides a weekly visit by nurse and bather, I can call Chaplin and Social worker to put final affairs in order. I have a sense of peace. If these caregivers are typical. I heartily agree that end of life care should be started as soon as possible. Just because my body is shutting down don’t think my brain is not active!

  3. Jennie O'Brien June 12, 2017 at 8:15 am #

    I totally agree. I worked in an aged care facility that had a dedicated 9 bed palliative care unit. Our facility manager fought long and hard to get it up and running. We received referrals from hospitals, the community and our own aged care facilities. Whilst it was difficult at times, it worked really well. One of the many positive aspects of having palliative care on site was the other residents in the facility also received improved end of life care that started long before the palliative stage.

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