Spotlight on dementia and end of life care

Palliative Care Australia and Alzheimer’s Australia have released a joint statement to raise awareness of the needs of people with dementia at the end of life. Plus the Rudd government announces palliative care consortium.

President of Alzheimer’s Australia Ita Buttrose.

By Linda Belardi.

Palliative Care Australia and Alzheimer’s Australia have today released a joint statement to raise awareness of the need for dementia-specific palliative care, including greater training for health staff and initiatives to reduce the number of avoidable admissions to hospital.

Alzheimer’s Australia National President, Ita Buttrose and Senior Australian of the Year and palliative care physician, Professor Ian Maddocks, launched the document at the Palliative Care Conference in Canberra today.

Ms Buttrose said dementia was a long and unpredictable disease, which set it apart from other terminal conditions. Complex issues around capacity also complicated the provision of end of life care.

According to the joint position statement, in 2009-2010, 5600 people with dementia died in a hospital setting. To help reduce the number of unnecessary transfers to hospital, both organisations called for increased access to palliative care services in the community as well as to specialist palliative care services.

The statement said the possibility of transfer to hospital should be discussed as part of a person’s advance care plan to ensure that decisions are made early about the reasons which would necessitate a transfer.

Ms Buttrose said it was essential that a palliative approach to care and support was available to people with dementia from the onset of the dementia through to the advanced stages of the condition.

Professor Ian Maddocks said health professionals working in aged and primary care, as well as in the acute health system, should encourage individuals to discuss and document their end of life care wishes. Advance care plans should also be regularly reviewed by the family and the person to respond to changes in wishes and needs of the person as the dementia progresses, he said.

Equipping aged care

In relation to aged care, the position statement said that all residential aged care facilitates should be able to provide person-centred palliative care to residents when required, including the appropriate care and management of behavioural and psychological symptoms of dementia.

“Staff need to have training in palliative care, advance care planning and the assessment of symptoms such as pain and distress for the person with dementia,” the document said.

Good communication with the family about the person’s advance care plan was emphasised.

Palliative care consortium

Elsewhere, the Rudd government announced on Wednesday the results of a Department of Health and Ageing tender to deliver specialist palliative care and advance care planning advisory services for aged care providers and GPs as part of the Living Longer, Living Better Reforms.

A consortium headed by Palliative Care Australia and Austin Health in Melbourne was awarded the $14.95 million grant by the government until 2016.

The 7-member consortium includes Austin Health’s Respecting Patient Choices, Palliative Care Australia, CareSearch, the University of Queensland, Queensland University of Technology, the Australian and New Zealand Society of Palliative Medicine, Leading Age Services Australia, and Aged and Community Services Australia.

Minister for Mental Health and Ageing, Senator Jacinta Collins said the initiative was designed to strengthen the links between GPs, aged care facilities and palliative care services and would include a 24-hour national telephone line to provide advice to aged care staff and GPs on palliative care and advance care planning issues.

Election 2013 – Labor announces Hazel Hawke research chair

In its final days of campaigning, the Rudd government also announced a set of dementia research initiatives, including a plan to fund a new Hazel Hawke chair in dementia research (up to $4 million over two years), as part of its pitch to voters.

The Labor party said it would create five Hazel Hawke Memorial Scholarships up to the value of $45,000 annually (per scholarship) for students to undertake doctoral studies on the subject of dementia.

Alzheimer’s Australia would also be provided with $5 million in dedicated funding over four years to help establish a Dementia Learning Centre. 

Under Labor’s plan the government would also rename the Dealing with Cognitive and Related Functional Decline in Older People Partnership Centre as the Hazel Hawke Dementia Partnership Centre. Funding for these commitments has already been included in the budget.

Last week, the Opposition leader Tony Abbott announced the Coalition’s election commitment to increase dementia research by an additional $200 million over five years.

Tags: alzheimers-australia, dementia, election-2013, hazel-hawke, palliative, palliative-care-australia,

1 thought on “Spotlight on dementia and end of life care

  1. Awareness must be driven by Leaders: therefore it is always enlightening to see the pro-activeness and dedication from Ms Buttrose and Mr Maddocks. Their specific areas of expertise display a major concern about the services to manage symptoms such as Behaviours of Concern for almost 300, 000 people currently living with dementia type illnesses(of which, 50 to 70% are diagnosed Alzheimer’s Disease cases – in itself a physical and terminal illness of the brain) and the uncomfortable – often excruciating pain and depressive conditions in End of Life Care, in particular for cancer sufferers.
    Awareness must become Reality through well assessed and well planned Action and Strategies: therefore it is refreshing to see that current and potential Political Leaders regularly pledge funding for further Research, Training, Employments and Care Services; however convincing, limited or untimely these pledges may be presented – The Labor’s LLLB has been in place for a long time, and in most cases delivering much needed assistance to individuals and families in various settings, with some difficulties and challenges indeed, but also with a strong degree of consistency; The Coalition’s long term approval and support of The LLLB shows that The Liberals and other Coalition Parties do not see “Eye to Eye” in their Vision about Aged Care, and only released The HLBA “Policy” one day before the Federal Election, with very little policy detail, and simply a view of Red Tape Removal to improve the current system. If Continuous Improvement is a “new creation” in Mr. Abbott’s book, then he will need to be more creative should he win today… the question is how much Creativity and Red Tape Removal will his National votes allow him to explore? The fact that the information is only available in the Liberal Party’s Website show that other Coalition Tendencies do not agree as clearly as they should.
    Awareness must reach deeper and more intimately into the relevant members of the Community: therefore it is important to highlight that current DEEWR Training Packages for Nationally Accredited Qualifications such as CHC30212 – Certificate III in Aged Care and CHC40108 Certificate IV in Aged Care, address specific Skills and Knowledge in both these Areas of Dementia and Palliative Care in Core Units of Competency. In addition, Supervised Practical Placement in Residential Aged Care Facilities include specific Expected Outcomes (1.6, 2.1, 2.2, 2.3, 2.8, 2.9, 2.13) under the Standards of Accreditation – I would never “cut” this Red Tape in the Process of Accreditation.
    Awareness must be clearly understood, studied and learnt by all those who are employed to Asses, Plan and Implement Individualised Care Plans (even in HACC Settings with the current EACH & EACHD Service Packages). It has been 16 Years since the Writing of the Aged Care Act, 1997 and The Aged Care Standards of Accreditation… much longer since the HACC Act, 1985 and the now Community Care Common Standards; let us place the responsibility on those who should be acted on these legislations:
    – RTO’s to deliver Competent and High Quality Vocational Training and Education in Aged Care – not just get paid to issue a Certificate
    – HACC & RACF Service Providers, to support Education through Supervised Practical Placement Agreements with RTO’s and Continuous Improvement through Complaince and Staff Professional Development
    – ACAT’s and ACAS’s must continue to be accessible and simplified in their Person Centered Approach.
    – Personal Care Staff to implement Quality Care Strategies based on Knowledge, Skills and Experience
    – The Department and the Accreditation Agency, as well as HACC to support the Auditing and ACFI Processes with Information and Assistance.
    But, wait! Is this not what we are doing today? If you are, then set the alarm clock and head off to work nice and early with a Big Smile on your face… All of the above are in place; if they are not, we have the power to fix it from within.
    Awareness must be within ourselves: Passion, Empathy, Caring Attitude, Humanitarian Approach!

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