Australia’s only specialist palliative care nurse practitioner employed by an aged care provider, Peter Jenkin is making a significant contribution to his organisation.
South Australia is leading the way in the trial and development of Australia’s only specialist palliative care nurse practitioner employed directly in aged care.
Peter Jenkin from Resthaven, a large SA not-for-profit organisation, works across seven metropolitan aged care facilities as well as a small number of community services.
He says as a permanent member of staff he is able to create the structural and cultural change that is necessary to influence long-term outcomes.
“A lot of the education I do with staff is one-on-one and in real time,” he says, which evidence suggests is the best way to learn.
The addition of a NP to the team has also contributed to more timely access to care and a reduced reliance on stretched specialist palliative care services.
“When someone deteriorates fairly quickly you need that responsiveness and that is something that I can provide. It’s not about substituting for a GP because they have a very particular role. My role is really about adding value to what they do,” Jenkin tells Australian Ageing Agenda.
Managers and staff also report significant improvements in the quality of the communication with families around end of life care decisions in the months and weeks prior to the death of a loved one. Advance care plans are also consistently reviewed to ensure the residents’ wishes are known and respected, he says.
Jenkin is currently in the process of conducting a formal evaluation of his role, which will measure the impact on areas such as advance care planning, the use of palliative care conferences, end-of-life care pathways, external referrals and the appropriateness of hospital admissions.
While he says the NP model at Resthaven is delivering positive outcomes for both clients and staff, in the long-term the financial viability of the NP role will need to be addressed to facilitate the wider take up of NPs in aged care.
Industry barriers
Reflecting on sector-wide challenges to the delivery of high quality palliative care, Jenkin says access to GPs, a skilled aged care nursing workforce and after hours support are significant issues.
Access to state-funded specialist palliative care services is also highly variable, which demonstrates the value of the sector building its internal specialist capacity.
Jenkin says every aged care organisation should have a clear point of contact with a specialist palliative care service to foster better linkages between the specialist palliative care and aged care sectors.
The funding available to care recipients on home care packages is also insufficient to provide the necessary care and support to clients who wish to die at home, says Jenkin. “That’s why unfortunately those who are on home care packages, even at the highest level, still end up either transitioning across to residential care or end up in an emergency department and then frequently die in hospital.”
Jenkin says while he is encouraged by recent positive developments in the education and training of aged care workers in a palliative care approach, ultimately the sector needs to be adequately resourced to deliver better quality care to clients at the end of life.
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As an aged care GP I have had first hand experience with this model of care and the benefits to patients, families and to aged care facilities.
Having worked along side Peter I agree that Nurse Practitioners can add huge value to General Practice and bring expertise and experience that is unique and practical.
Great work Peter!