PubMed Searches Aged Care Facilities Free full text only    Strongest evidence    Everything All citations    Strongest evidence    Everything    Last 3 months About these searches Review Collection     Site of Care    Older People

Aged Care Nurses working in Aged Care speak of issues they face.

In June 2006 there were 2,931 residential aged care services providing 164,008 places for people requiring care. There has been a consistent trend of rising dependency levels among residents. In 2005/6 for 87% of resident separation reason from the Residential Aged Care Facilities (RACF) was due to death with 17% of those who died having stayed less than 3 months, 19% between 3 months and a year, 45% for 1 to 5 years and 20% for more than 5 years. [1]

Issues in Aged Care Facilities

Residential Aged Care Facilities (RACFs) in Australia must meet Accreditation Standards to qualify for government funding. In 2008 a new funding instrument is being introduced – the Aged Care Funding Instrument (ACFI). It has provision for claiming for support for residents who require pain management or palliative care.

Key issues in providing palliative care in RACFs include:

1. When a palliative approach should be implemented
2. The interface between RACFs and specialist palliative care services
3. General practitioners' knowledge of palliative care
4. Skill mix of staff working in RACFs
5. Education in a palliative approach for staff working in RACFs
6. Access to adequate resources.

What does the literature say?

Oliver DP, Porock D, Zweig S. End-of-life care in US nursing homes: a review of the evidence. J Am Med Dir Assoc. 2004 May-Jun;5(3):147-55.

Key Documents

• Standards for Aged Care Facilities Commonwealth of Australia 2007
  The following standards reflect the quality management and services expected of a RACF. RACF are assessed against these standards to determine their suitability for accreditation. There is a standard for pain management and a standard for palliative care.
• Aged Care Funding Instrument (ACFI) Instrument Commonwealth of Australia 2008
  Assesses funding for residents in Australian residential aged care facilities. Includes a palliative care component.
• Guidelines for a Palliative Approach in Residential Aged Care (Enhanced version) Commonwealth of Australia, 2006 
  Evidence based guidelines to help practitioners in applying a palliative approach in a residential aged care facility.
• Training Modules for a Palliative Approach in Residential Aged Care PCA 2006 
  These training resources can assist in the implementation of a palliative approach by providing staff and management with an understanding of the benefits.
• Better Palliative Care for Older People  World Health Organization, 2004 
  Presenting the palliative care needs of older people, their different illness trajectories, evidence of underassessment of pain and other symptoms, their need to be involved in decision-making, evidence for effective palliative care solutions, and issues for the future.
• The route to success in end of life care - achieving quality in care homes NHS, 2010
  This UK document outlines a pathway from initial discussion about death and future care, to assessment and the provision of high quality co-ordinated care and support through to the final days and end of life.
• Guide to End of Life Care for Seniors University of Toronto and University of Ottawa, 2000 
  This document provides a clinical resource regarding End of Life Care for Seniors.
• Pain in Residential Aged Care Facilities - Management Strategies Australian Pain Society 2005 
  This Australian publication addresses the issue of pain, its identification and its management among residents of residential aged care facilities. 
• The PMG Kit for Aged Care Commonwealth of Australia, 2007
  The Pain Management Guidelines (PMG) Kit for Aged Care has been developed for use with the Pain in Residential Aged Care Facilities: Management Strategies to assist Residential Aged Care Facilities to better manage residents’ pain.
• Volunteering for Palliative Residential Aged Care Edith Cowan University 2005
  These publications outline resources that will support palliative care volunteers in residential aged care facilities.
• SCARE Research Briefing 10:Terminal care in care homes 
  The topic of this briefing is the provision of care to terminally ill people aged over 65 years in aged care facilities.
• Raising Standards for elderly people dying in care homes 
  From Gold Standards Framework – reprinted from European Journal of Palliative Care

Websites 

• A Palliative Approach in Aged Care Facilities Rural Health Education Foundation, 2005 
  Video broadcast examining issues surrounding early identification, assessment and treatment of pain, and related physical, cultural, psychological, social and spiritual needs.
• Australian and New Zealand Society for Geriatric Medicine 
  Includes position statements relating to the provision of aged care.
• For Health Professionals
  Provides access to a range of resources developed, or supported by the Department of Health and Ageing, for clinical staff in residential aged care.
• The Centre for Cultural Diversity in Ageing is an online source of information on culturally appropriate aged care.
• Medication Management in Residential Aged Care,
  An NPS inititiative that 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

Education and training

• Postgraduate program for Palliative Care in Aged Care 
  Postgraduate coursework programs for Palliative Care in Aged Care at Flinders University.
• Training resources for the Guidelines for a Palliative Approach in Residential Aged Care 
  The Department of Health and Ageing funded Palliative Care Australia to undertake a project Introducing the Guidelines to a Palliative Approach in Residential Aged Care to raise awareness of the Guidelines. Various Training Resources have been produced as part of that project. 

References

1. Australian Institute of Health and Welfare 2007 Older Australia at a glance 4th Edition, Canberra Australia.

This page was created on 19 May 2008
Last updated 20 December 2011*