From knowledge to practice: Reflecting on the Palliative Care in Aged Care Forum

An article written by Prof. Jennifer Tieman, Director, Research Centre for Palliative Care, Death and Dying

Acknowledgement: AI-assisted drafting tools (Microsoft Copilot) were used to adapt conference presentation slides. All revisions, interpretations, and conclusions are the author’s own.

There is no shortage of evidence on the value of palliative and end‑of‑life care. We know it improves quality of life, supports families, and helps care teams deliver more coordinated and compassionate care. Yet translating this knowledge into everyday practice, particularly in aged care, remains challenging. However, given an ageing population, the pressures on our health and aged care systems and services are growing.  

Data on place of death provides a useful snapshot of how care systems are currently working as people age and die. For people aged 65 and over, hospital is where most people die, followed closely by residential aged care, but once you are over 85 years residential aged care becomes the most likely place of death. This data reminds us that aged care services are already providing care to people in the last year of their life through to end of life. It also highlights how closely aged care is connected to hospitals, general practice, specialist palliative care, families, and community services. Palliative care does not sit neatly in one place; it sits across sectors, staff and settings.

Why evidence still matters

In busy care environments, it can be tempting to see research as something distant from practice. But evidence plays a crucial role. It helps us understand what works, what doesn’t work, and what needs to be adapted for different settings. It also highlights variation, showing us that outcomes can be shaped by context, population diversity, workforce capability, organisational culture, and available resources.

Palliative care studies offer us guidance on effective symptom management, communication, advance care planning, and coordinated care. The issue is not a lack of knowledge but rather how knowledge is taken up, sustained, and embedded into routine care. Implementation research also helps us here. Introducing new practices is about much more than choosing the “right” intervention. Success depends on leadership, staff engagement, clarity of roles, training, data systems and organisational culture.

Aged care is already familiar with quality improvement approaches, and this is a valuable approach to implementing changes. It allows services to start where they are, test changes on a small scale, learn from feedback, and build momentum over time. Importantly, they acknowledge that change is rarely linear and that adaptation is not failure, but part of the change process.

Being clear about what we mean by palliative care

When considering how to address palliative care improvements, one of the most important starting points is being clear about what we are mean by palliative care.  Palliative care is often thought about as the last few days of life or as what the specialist palliative care team does when they visit.  In reality, it is an approach to care that focuses on quality of life, early identification of needs, ongoing symptom assessment, good communication, and thoughtful planning over time.

Within aged care, palliative care is explicitly referenced as Outcome 5.7 of the strengthened Aged Care Quality Standards while relying on all the standards. Australia has a wide range of frameworks to support palliative and end‑of‑life care. These include aged care legislation and quality standards, national palliative care strategies, advance care planning frameworks, and program‑level models such as ELDAC and palliAGED. Both the palliAGED and ELDAC projects help services align care delivery, workforce development, digital systems and reporting requirements, rather than treating these as separate competing tasks.

From “what do we need?” to “what do we need to do?”

Moving from knowledge to practice usually starts with a simple but important question: what do we need to do? It is important to consider what you are trying to solve.  For some, the driver may be addressing Outcome 5.7. For others, it may be workforce wellbeing, financial viability, or responding to clear gaps in care.

Once the need is clear, the next steps become more manageable: scanning for options that fit the local context, weighing up feasibility, gaining leadership support, and bringing together the right mix of people to lead the work. Planning for sustainability, not just initial implementation is essential.

We should also remember that not every improvement needs to be large or complex. Reviewing assessment tools, introducing after‑death audits, embedding palliative care education into staff orientation, or offering structured bereavement support are all discrete actions that can make a real difference.  A simple place to start is in the Supporting Services section of the palliAGED website.  This provides access to a range of resources.  The Being Prepared for Palliative and End-of-Life Care is a provider-level solution  while practical resources such as Practice Tips for Nurses and for Careworkers or the Introductory Learning Modules are immediate first steps to improve care.  Over time, these actions shape a culture where palliative and end‑of‑life care is seen as a normal and valued part of care.

Author

Professor Jennifer Tieman BSc(Hons) MBA PhD FAICH

Matthew Flinders Professor

Director, Research Centre for Palliative Care, Death and Dying (RePaDD)