Developing and testing a strategy to enhance a palliative approach and care continuity for people who have dementia.

This project, funded by the Australian Government Department of Health and Ageing’s Local Palliative Care Grants Program, addressed a palliative approach for people with dementia at the end of life. These people receive services in the community, in hospital, and in residential care. It was therefore important to address best practice and care continuity across all these health care sectors. A local Community of Practice (CoP) was proposed as a strategy to achieve this.
 
Two CoPs each comprised members nominated by local acute, community, and residential providers plus representation from general practice/independent practitioners. One CoP was in Perth, Western Australia, the other in Launceston, Tasmania. The CoPs were supported to (a) identify practice areas that needed to be addressed and (b) champion best practice.

Project aims were to document: (i) changes driven by the communities of practice to improve the delivery of a palliative approach for people with dementia drawing close to death; (ii) changes in partner organizations’ staff/practitioner characteristics during the study (their knowledge of a palliative approach and dementia; confidence delivering palliative care; views on death and dying, palliative care, and a palliative approach for dementia); (iii) outcomes from perspectives of family carers, care providers, and community of practice members; (iv) the extent to which changes enhanced practice and care continuity; and (v) barriers to and facilitators of successful CoP implementation.
 
The lead organisation was Alzheimer’s Australia WA. The principal investigator in WA was Associate Professor Chris Toye from Curtin University’s School of Nursing & Midwifery, Curtin Health Innovation Research Institute (CHIRI). Her co investigators from WA were Professor Barbara Horner (CHIRI); Professor Moyez Jiwa (CHIRI) and Ms Kristi Holloway, PhD candidate (School of Nursing & Midwifery and CHIRI).
 
In Tasmania, the principal investigator was Professor Andrew Robinson from the Wicking Dementia Research and Education Centre (WDREC), University of Tasmania. His co investigators were Associate Professor Fran McInerney (WDREC); and Ms Sharon Andrews, Research Fellow (WDREC). Professor Jenny Abbey, Honorary Senior Research Fellow (WDREC), also contributed substantially to the project.
 
In addition to Alzheimer’s Australia WA, partner organisations in Perth were the Western Australian Department of Health’s Bentley Health Service;  Uniting Church Homes (WA),  Southern Cross Care (WA) Inc., and the Canning Division of General Practice.
 
Partner organisations in Tasmania were Alzheimer’s Australia Tas., OneCare Limited, Southern Cross Care (Tas) Inc., the Tasmanian Department of Health and Human Services’ Launceston General Hospital, and the Northern Tasmanian Division of General Practice Inc.

This project was completed in WA in 2011, although a follow up study continued into 2012 in Tasmania. Publications of study findings are now in progress.
 
For further information contact Chris Toye, Associate Professor, Older Persons' Health Care, School of Nursing & Midwifery, Curtin Health Innovation Research Institute (CHIRI), Curtin University
Tel +61 8 9266 1756 (Mondays and Wednesdays) +61 8 9346 3041 (Thursdays and Fridays)
Fax +61 8 9266 2959
Email c.toye@curtin.edu.au

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