Discipline specific evidence - Allied Health
X

Discipline Specific Evidence

Practice guidelines are important for allied health professionals working in aged care and palliative care for several reasons:

  • Evidence-based care: Practice guidelines are based on the best available evidence and research. By following these guidelines, allied health professionals can provide the most effective care.
  • Improved outcomes: Guidelines can improve patient outcomes by ensuring that best practices are followed, leading to better health outcomes and quality of life for older people.
  • Communication: Guidelines promote various methods of communication between healthcare providers, care coordinators, and the person, which offers improved health outcomes for the older person.
  • Regulatory compliance: Practice guidelines may be required by regulatory bodies or accrediting organisations to ensure compliance with safety and quality standards. Compliance with guidelines can help allied health professionals and their organisations avoid legal and regulatory issues. Older people can also be confident they are receiving a safe standard of care.

Evidence-based guidelines for speech pathologists in palliative care provide recommendations for the assessment and management of swallowing and communication difficulties. Whilst Speech Pathology Australia does not have a specific best practice document or clinical guideline for the palliative and end-of-life care management of older adults in aged care, relevant practice guidelines for the profession can be consulted to inform practice in the management of symptoms and supporting quality of life outcomes. 

Practice Guidelines
Speech Pathology Australia

Relevant practice guidelines available in the Speech Pathology Australia member portal include:

  • Dysphagia
  • Informed Choice and Shared Decision Making with People who Eat and Drink with Acknowledged Risk
  • Augmentative and Alternative Communication
  • Voice Best Practice Principles Resource

The Australian Physiotherapy Association offers general palliative care information for physiotherapists and consumers on their website. The Five facts about palliative care in aged care page summarises symptom management and ways physiotherapists can deliver care to people with life-limiting illnesses, to improve their quality of life and optimise their function.

Practice Guidelines

At present, the Australian Physiotherapy Association does not have publicly available palliative care guidelines. However, the National Institute for Health and Care Excellence (NICE) in the UK has developed guidance on the care of dying adults in the last days of life, which includes recommendations for physiotherapy interventions to manage physical symptoms, such as breathlessness and secretions.

In addition, the following following local and overseas resources also offer evidence-based recommendations and practical advice to support you in providing high-quality care to older adults receiving palliative care.

Australia / New Zealand

International documents that may be used to inform practice

OT Australia is the national body, and has developed a position paper Position statement: Occupational Therapy and Palliative Care (2015) and a Capability framework for Occupational Therapists working with older people (Aged Care) (614kb pdf). These documents outline the role of occupational therapy in working with older adults and in palliative care in Australia, taking into account the contextual factors experienced by the profession in this practice setting.

The Occupational Therapy Board of Australia has also developed a series of competency standards which refer more generally to OT practice not specific to palliative care. The video provides information on how to apply the standards to you and your practice.

International documents that may be used to inform practice

Dietitians Australia is the leading voice in nutrition and dietetics in Australia. While there are no specific guidelines for dietitians working in palliative care, other reference documents are available which can inform practice in the management of symptoms and supporting quality of life outcomes.

Australia / New Zealand

International documents that may be used to inform practice

European Society for Clinical Nutrition and Metabolism (ESPEN)

Evidence-based practice guidelines for social workers provide recommendations for the assessment and management of psychosocial and spiritual issues in patients receiving palliative care. These guidelines aim to support social workers in delivering effective and appropriate care to patients with life-limiting illnesses, to improve their quality of life and well-being.

Practice Guidelines
Palliative Care Social Work Australia (PCSWA)

Australian Association of Social Workers (AASW)
  • The Practice Standards 2023 outline the practice expectations of all social workers. They are designed to guide social workers to ensure they fulfil their professional practice responsibilities more broadly across all practice areas.
  • The Code of Ethics 2020 binds the practice of all social workers in Australia.

International documents that may be used to inform practice

Older people at or approaching the end of their life commonly experience psychological symptoms of distress such as anxiety and depression. However these are often under-recognised and undertreated including by clinicians.

At present, there are no best local best practice guidelines, but the American Psychological Association (APA) has published Resolution on palliative care and end-of-life issues and justification (2017). This document summarises how psychologists should possess to provide effective care to patients and their families in palliative care settings. Some key recommendations from the APA guidelines for psychologists working with older adults in palliative care include:

  1. Assessing and addressing the psychological and emotional needs of patients and their families, including anxiety, depression, and grief.
  2. Collaborating with interdisciplinary teams to address the physical, psychological, and spiritual needs of patients and their families.
  3. Providing education and support to patients and their families about the palliative care process, including information about treatment options, advance care planning, and end-of-life decision-making.
  4. Recognising and addressing cultural and social diversity in the provision of care.
  5. Self-care for psychologists working in palliative care settings, including managing emotional distress and preventing burnout.
  6. These guidelines provide a framework for psychologists to provide high-quality, patient-centred care in palliative care settings, with the ultimate goal of improving quality of life for patients and their families. These principles of care are also discussed in more detail in the palliAGED evidence summary.

Pharmacists play a critical role in palliative care, as they are responsible for ensuring the safe and effective use of medications to manage pain, symptoms, and other aspects of care for patients nearing the end of life.

Advanced Pharmacy Australia (previously known as The Society of Hospital Pharmacists of Australia (SHPA)) has developed guidelines for pharmacists working in palliative care. These guidelines provide recommendations for pharmacists in a variety of areas, including prescribing, communication, pain and symptom management.

Position statements and practice standards

International documents that may be used to inform practice

Further reading on the best practice role of pharmacists in palliative and end-of-life care