Overview
Medication management is a critical component of palliative care that aims to improve the quality of life of people with a life-limiting illness.13 Effective medication management contributes to better end of life outcomes because:
- a person’s pain and symptoms can be appropriately managed and alleviated
- planning and preparation enables medications to be administered as soon as a person’s needs change so they are comfortable, pain free and there is no delay in responding to deterioration
- family and friends are supported to understand the reasons a person may need or want to stop or start medications at the end of their life.
Each of these outcomes depends on thorough assessment, planning and management. Effective communication between those involved in the person’s care and clarity of roles and responsibilities is also vital.
Managing medications for people nearing the end of life can be challenging and involve many considerations. Effective risk identification and management underpins the delivery of safe, effective, and person-centred care.
This resource seeks to assist staff working in residential aged care to identity and address some of the key risks – be they legal, clinical, or communication risks - associated with managing medications during the palliative phase. It does not provide a comprehensive assessment of all risks, but rather prompts staff to apply risk-based thinking (noting that there will be different risks relevant to different people and aged care facilities).
This resource integrates principles and requirements of the Aged Care Quality Standards including person-centred and rights-based care, consumer dignity and choice, dignity of risk, quality of life, ongoing assessment and planning to reflect a person’s needs, goals and preferences, and continuous improvement. It also draws on the National Palliative Care Standards including comprehensive assessment of need, care planning and quality improvement.
The Aged Care Quality Standards are currently being revised and strengthened.
The existing Standards [Standard 3(3c)] require ‘the needs, goals and preferences of consumers nearing the end of life are recognised and addressed, their comfort maximised and dignity preserved.’
The Consultation Paper: Aged Care Quality Standards Review signals the intent for a more detailed focus on end of life care. A new dedicated Standard on Food & Nutrition, and more detailed requirements for Clinical Care (e.g., choking and swallowing and malnutrition and dehydration risks) are foreshadowed. The strengthened Quality Standards are due to come into effect in mid-2024.