Guidelines for a palliative approach to care for older adults living in the community

Issue: A palliative approach to care for older adults in the community with life limiting illness, frailty, or extreme old age aims to promote quality of life in this group; it addresses physical, psychosocial, and spiritual symptoms plus family needs, including those due to bereavement. This project, funded by the Australian Government Department of Health and Ageing (DoHA), has produced evidence based clinical practice guidelines and other recommendations, the documents complementing previously developed residential care guidelines (DoHA, 2006).

Discussion: A national consultative process and reference group advice guided the project. There were several concurrent approaches to document development. Questions relevant to the domains specific to community aged care, Service Delivery in the Community and Support for Family Carers were addressed with systematic reviews and resulted in evidenced based guidelines as well as recommendations without such an evidence base, Good Practice Points (GPPs). The approach for other areas was substantially different. For the domains of Spiritual Support, Psychosocial Support, and Advance Care Planning, literature reviews were examined and GPPs developed. For domains specific to Australian Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse populations, groups with perspectives or care needs requiring special consideration (eg, veterans, people with Motor Neurone Disease), relevant literature was discussed, leading to GPP development. For the domain of Symptom Assessment and Management, clinical practice guidelines were reviewed and links to these included as appropriate. The main document is a resource for health care professionals; plain English booklets were developed for older adults and their families as well as for care workers.

Conclusion: These documents provide comprehensive guidance for a palliative approach to care in the community setting) thus helping to facilitate quality care for older adults.

Reference: Australian Government Department of Health and Ageing. (2006). Guidelines for a palliative approach in residential aged care - Enhanced version. Available from http://www.health.gov.au