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Aged Care
Nurses working in Aged Care speak of issues they face. |
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The Australian population reached 20 million in 2006 with 13% (or 2,687,000 people) aged 65 and over. Women, regardless of cultural backgrounds, live longer than men. So the proportion of women increases significantly with age. The proportions of women in the '65-74 years', '75-84 years' and the '85 years and over' categories were 51%, 56% and 67%. [1]
People over the age of 65 are culturally diverse with 35% born overseas and with only 39% from English-speaking countries. The majority of older people live in private dwellings either alone or as members of a family group. Only 6% reside in non-private dwellings such as residential aged care facilities, guest houses or supported accommodation. [1]
Issues common to older people requiring palliative care
Older people are more likely to have complex needs that require partnerships between health providers in different settings. The interface between geriatric and palliative care disciplines is crucial. As people age the diseases they die from changes. Cancer is the main cause of death for people between 65 and 84 years and cardiovascular disease is the main cause of death for those over 85 years. [2]
A consequence of the population ageing is the decrease in the availability of younger carers. For many older people informal care support is provided by an elderly spouse. With the changing demographics of the family and increased migration the opportunity to have informal care provided by an extended family member is diminished. [3]
There is evidence to suggest there are common issues around under-assessment and under-treatment of older people who require palliative care. [4] In These include:
- Under-assessment of pain
- Lack of information involving decision making
- Lack of home care
- Lack of access to specialist services
- Lack of palliative care within residential aged care facilities.
Key documents
- Ageing and Aged Care in Australia
Overview of Australian's government's approach
- Palliative Care for the Older Person
Australian and New Zealand Society for Geriatric Medicine, Position Statement 16, 2009
- Better Palliative Care for Older People
World Health Organization, 2004
- Fisher R, Ross M & MacLean (eds) Guide to End of Life Care for Seniors University of Toronto and University of Ottawa, 2000
- Wenger N and Rosenfeld (2001) Quality Indicators for End-of-Life Care in Vulnerable Elders. Annals of Internal Medicine 135(8): 677-685
- Coventy, P., Grande, G., Richards, D. and Todd, C. (2005). Prediction of appropriate timing of palliative care for older adults with non-malignant life-threatening disease: a systematic review. Age and Ageing 34: 218-227.
- Ahmed, N., Bestall, J., Ahmedzai, S., Payne, S., Clark, D. and Noble, B. (2004). Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals. Palliative Medicine 18: 525-542.
- Gruenewald D and White E (2006) The illness experience of older adults near the end of life: A systematic review. Anesthesiology Clinics of North America 24(1)163-180.
Websites
- Aged Care Australia
Provides the community with access to government and non-government information and services about aged care.
- Ageing Research Online
Ageing research has become increasingly important in recent years as the trend towards the structural ageing of populations has become a significant concern for Governments. Ageing Research Online provides access to information on ageing relevant policy responses, research initiatives and much more.
- Palliative and End of Life Care of Older People,
British Geriatrics Society, 2004 A document produced by the British Geriatrics Society on good end of life care for older people.
- Gold Standards Framework
Systematic approach to optimising the care for patients nearing the end of life in the community.
- Liverpool care pathway for the Dying
Continuous quality improvement framework for care of the dying irrespective of diagnosis or place of death.
- Centre for Cultural Diversity in Ageing
Provides online information on culturally appropriate aged care.
- Medication Management in Residential Aged Care
This website developed by the National Prescribing Service provides access to resources and tools related to medication management. It is designed for registered nurses working in residential aged care. Resources and tools have been reviewed to assess their usefulness.
Relevant journals and online books
Resources
ComPAC This is a project is develop evidence-based guidelines for a palliative approach for aged care in the community.
Related CareSearch pages
Aged care facilities
CareSearch Review Collection: Aged
References
- Australian Institute of Health and Welfare 2007 Older Australia at a glance 4th Edition. Canberra, Australia.
- AIHW National Mortality Database available at www.aihw.gov.au.
- NATSEM Who's going to care? Informal care and an ageing population University of Canberra 2004.
- Davies E & Higginson IJ (eds) 2004 Better Palliative Care for Older People World Health Organization.
This page was created on 15 May 2008 and is due for review in May 2010
Last updated 14 July 2009