Development of the Guidelines
The development of the Guidelines for a Palliative Approach for Aged Care in the Community Setting was funded by the Australian Government Department of Health and Ageing in 2005 and involved extensive public consultation. Thirty two key questions that needed to be addressed were developed from an initial consultation phase, with input from an expert reference group. Five of these questions were prioritised and addressed via systematic reviews of the research evidence.
Three questions addressed the physiological and/or psychological health of the older person (the client) and/or their family carer, asking whether or not implementing post-acute transitional care programs, crisis care, or respite care leads to improved health. Five evidence based guidelines were developed as a result.
The two other questions addressed education for family carers. The first asked if education in disease specific areas (eg, dementia care or cancer care) improved family carer confidence, competence, and/or health. The remaining question asked if education in end of life care improved the family carer’s experience at that time and/or their post bereavement health. There was insufficient evidence to provide a guideline regarding education in end of life care. However, three evidence based guidelines were produced to guide practice related to education for family carers in disease specific areas (cancer care, dementia care, and post-stoke care).
In addition to the evidence based guidelines, the main guideline document provides over 150 Good Practice Points drawn from in depth literature reviews and expert opinion; it also provides links to existing guidelines and additional resources. Chapters explore a palliative approach to care, how it may be delivered in the community setting, and how family carers may be supported and care planning facilitated. Types of care addressed are physical, spiritual, and social. Needs of particular groups of people are considered, including those of Aboriginal and Torres Strait Islander people; people from diverse cultural and language groups; gay, lesbian, bisexual, transsexual, or intersex people; people living alone; and people having a mental illness, post traumatic stress disorder, or an intellectual disability. The needs of those experiencing motor neurone disease, Parkinson’s disease, or dementia are also considered in some depth.
The main document is supplemented by two booklets in ‘plain English’, designed for use by support workers and clients/family carers respectively. The breadth and depth of the suite of guideline documents serve to emphasise the extensive nature of community care for older people who are frail or unwell and the extensive skills and knowledge required to both provide appropriate care and support family care provision.
Four documents are available for downloading:
Holloway K, Toye C, McConigley R, Tieman J, Currow D, Hegarty M. National consultation informing development of guidelines for a palliative approach for aged care in the community setting. Australas J Ageing. 2015 Mar;34(1):21-6. doi: 10.1111/ajag.12083. Epub 2013 Oct 18.
Toye C, Blackwell S, Maher S, Currow DC, Holloway K, Tieman J, Hegarty M. Guidelines for a palliative approach for aged care in the community setting: A suite of resources. Australas Med J. 2012;5(11):569-74. doi: 10.4066/AMJ.2012.1400. Epub 2012 Nov 30.
The Australian Healthcare and Hospitals Association (AHHA) has been funded by the Department of Health to develop an online training program based on the Guidelines for a Palliative Approach for Aged Care in the Community to help health professionals who provide palliative care to aged persons in the community.
Related CareSearch page
Palliative care online training
Last updated 21 May 2015*