In Australia, the aged care sector is very diverse. Management positions may have many different job titles and there can be significant variation in their duties.
In small facilities, the registered nurse may be responsible for many management tasks. In large organisations there may be a team of people responsible for management. They may be called director of nursing, site manager, care manager, quality manager, manager of staff development or administrator or CEO.
Managers in aged care have varied responsibilities in regard to provision of palliative care, they may include:
- Discussing care needs with family and facilitating family conferences
- Providing support and leadership to clinical staff to address care issues
- May be the liaison to palliative care services / other specialist providers or community volunteer program
- Disseminating information and providing resources to staff
- Identifying staff needs, counselling, support and debriefing.
- Ensuring staff are adequately trained and have access to continuing professional development in palliative care
- Ensuring residents, family, staff are aware of policies and procedures in regard to palliative care
- Undertaking, analysing and monitoring audits of palliative care services
- Identifying areas for improvement and implementing and assessing quality initiatives
- Developing / reviewing policies / procedures / models of care.
- May undertake or facilitate or collaborate on research projects in palliative care
- Implement government programs or initiatives (palliative approach in aged care, palliative care standards, standards for aged care).
- Submitting funding claims for palliative residents (ACFI)
- Ensuring legal obligations are met (storage and administration of DDA’s, adequate staffing).
Palliative care in RAC is currently a subject of debate at national level. The productivity commission report (Caring for older Australians 2010) identified palliative care as core business for RAC.
The Senate commenced an enquiry into palliative care in Australia, including a term of reference to palliative care in aged care, in March 2012, The report is due September 2012.
The Federal Government has funded several programs to introduce evidence-based palliative care to RAC under the EBPRAC program.
Projects implemented or improved the use of:
- end-of-life pathways
- advance directives
- medication for symptom control at end-of-life
- palliative care case conferencing.
Details of these projects are included in the final report of the EBPRAC program available from the Centre for Health Service Development (CHSD) website.
The Teaching and Research Aged Care Services (TRACS) initiative will fund integrated aged care teaching centres. To date 16 aged care facilities and universities have received funding.