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The views and opinions expressed in our blog series are those of the authors and are not necessarily supported by CareSearch, Flinders University and/or the Australian Government Department of Health.
In 2017 Palliative Care Australia undertook a review and update of the reference documents A Guide to Palliative Care Service Development: A population based approach and Palliative Care Service Provision in Australia: A planning guide. Together these key reference documents have provided a framework for the ongoing development of palliative care policy within the health care system for the last fifteen years.
Many people spend the last stages of their lives in aged care, and for that reason Palliative Care Australia believes that end-of-life care should be recognised as core business for residential aged care. Increasingly, aged care providers are recognising the need to ensure their workforce have the necessary skills and competencies to deliver high quality end-of-life care. Yet in spite of this recognition, access to quality palliative care services is far from guaranteed in residential aged care – particularly in rural and remote areas.
We all want the ‘best death possible’ for our loved ones and ourselves as we enter old age. So we need to ask ourselves, what are the barriers to accessing care that can support this, and will looking at the issue from a population or needs-based policy perspective help to ensure end-of-life care becomes core business for all aged care providers?
One of the statements we commonly see in research reports and in policy and service documents is a comment about an ageing population. The reality of a demographic change where people are living longer than ever before has been instrumental in driving rethinking around issues such as retirement age, superannuation access, healthy lifestyles and supportive living environments. Living longer does not however mean living forever, and an ageing population means we also need to consider how we support older Australians as they approach death.
Health professionals need to know the law that governs withholding and withdrawing life-sustaining treatment. Law is not at the centre of the clinical encounter, but it is part of the regulatory framework that governs these decisions. Failure to know and follow the law puts health professionals and their patients at risk. But we know there are gaps in health professionals’ legal knowledge in this area and this is not surprising either, given how complex and difficult this field of law is.
The release of the Guidelines for a Palliative Approach in Residential Aged Care (APRAC) and the Guidelines for a Palliative Approach for Aged Care in the Community Setting (COMPAC) were a significant advance in recognising and responding to changing population demography in Australia. They aimed to support the provision of palliative care for older people living in the community or in residential aged care by identifying and evaluating the evidence for care to promote quality of life for older Australians who have a life-limiting illness or who are becoming progressively frailer during old age. The two sets of guidelines were important landmarks nationally and internationally.