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:
- When a palliative approach should be implemented
- The interface between RACFs and specialist palliative care services
- General practitioners' knowledge of palliative care
- Skill mix of staff working in RACFs
- Education in a palliative approach for staff working in RACFs
- Access to adequate resources.
What does the literature say?
Parker Oliver, D., Porock, D. and Zweig, S. (2004). End-of-Life Care in US Nursing Homes: A Review of the Evidence. American Medical Directors Association 5: 147-155.
Key Documents
- Standards for Aged Care Facilities 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
Assess funding for residents in Australian residential aged care facilities. Includes a palliative care component.
- Guidelines for a Palliative Approach in Residential Aged Care Commonwealth of Australia, 2004 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 Commonwealth of Australia, 2004 This document assists 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.
- 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.
- Gold Standards Framework – CareHomes Provides an overview of the implementation of the Gold Standards Framework in Care Homes in the UK
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.
- Palliative Care and long term care settings for older people: Worldwide resources A new web resource for people engaged with care provision, education and research in palliative and long term care for older people has been created in the International Observatory on End of Life Care. This web resource has been established to provide a place where initiatives, information and contacts can be exchanged worldwide. Resources can be identified by country and by type.
- The Centre for Cultural Diversity in Ageing is an online source of information on culturally appropriate aged care.
Education and training
References
- Australian Institute of Health and Welfare 2007 Older Australia at a glance 4th Edition, Canberra Australia.
This page was created on 19 May 2008 and is due for review in May 2010
Last updated 13 November 2008