Care Pathways

End-of-life care pathways

Some facilities use their own version of a care plan for residents in the last stages of life, or one that is included in a care planning software package. Increasingly there is interest in the use of end-of-life care pathways. The Liverpool Integrated Care pathway for the Dying Patient (LCP) developed by the Marie Curie Palliative Care Institute is the most widely used and modified end-of-life pathway.

A recent systematic review on the use of the Gold Standards Framework in Care Homes programme, the Liverpool Care Pathway (or an Integrated Care Pathway) and educational / training interventions in nursing care homes within the UK found some evidence that improvements occurred in resident outcomes. [1]  A study of the implementation of residential aged care end-of-life care pathway (RAC EoLCP) for Australian aged care facilities suggested that the pathway improved resident outcomes and decreased inappropriate transfers to acute care. [2]

Advantages of care pathways:

  • Simplified documentation that facilitates comprehensive assessment and management of care needs
  • Allows for continuous evaluation of care and clear communication between care team
  • Can contribute to good palliative care outcomes and best practice in end-of-life care
  • Increased confidence of staff to manage the care of dying residents.

Advance care planning and end-of-life care pathways in the Australian RAC context

There have been a number of papers published in recent years. ACP and the use of care pathways at the end of life are active research areas for both acute care and RAC.
Both Federal and State Governments have sponsored projects to introduce ACP and End-of-Life Care Pathways to RAC:

  1. Kinley J, Froggatt K, Bennett MI. The effect of policy on end-of-life care practice within nursing care homes: A systematic review. Palliat Med. 2012 Jan 4. [Epub ahead of print]
  2. Reymond L, Israel FJ, Charles MA  A residential aged care end-of-life care pathway (RAC EoLCP) for Australian aged care facilities. Aust Health Rev. 2011 Aug;35(3):350-6.
  3. Silvester W, Parslow RA, Lewis VJ, Fullam RS, Sjanta R, Jackson L, et al. Development and evaluation of an aged care specific Advance Care Plan. BMJ Support Palliat Care. 2013 Jun;3(2):188-95. Epub 2013 Mar 15.
The Gold Standards Framework (GSF) in the UK is a systematic approach to optimising the care for patients nearing the end of life delivered by generalist providers
Last updated 30 January 2017