2012
ExcerptDementia is now the third leading cause of death in Australia. Palliative care for people with advanced dementia is a growing area of need, particularly in residential aged care facilities (RACFs), where over half of all residents in 2008 had a dementia diagnosis. Palliative care for people living with advanced dementia is frequently sub-optimal. For example, the person with dementia often has difficulty communicating, which can hinder symptom recognition and their involvement in care decisions. Lack of acknowledgement from staff that dementia is a terminal condition may mean the person with dementia is not offered the benefits that a dementia-focused palliative approach can offer. Equally health professionals need expert knowledge in managing swallowing difficulty, behavioural issues, delirium, planning future goals of care, and providing spiritual care in the face of advanced cognitive impairment.
To date, integrated care frameworks (ICF) and pathways, which are well recognized to guide excellent palliative care, have mostly focused on cancer care usually for shorter timeframes (the final hours and days of life) and without addressing the specific issues faced in dementia care. The ICF – D components will be outlined, in context of the principles underlying the framework and corresponding communication guide. The proposed quality framework with audit processes and educational framework will be discussed.
Future directions for the ICF – D with recent funding under Alzheimer’s Australia National Quality Dementia Care initiative will develop a suite of professionally designed web-based interactive care planning, communication guides with associated family factsheets, education modules for staff and audiovisual teaching materials. To ensure the materials are always up to date, a free dementia-specific filter will be also developed in collaboration with Caresearch to ensure health professionals can access up to date evidence and guidelines.