Palliative care is integrated into a resident’s overall care, as well as the care their family receives. The document, ‘Principles for Palliative and End-of-Life Care in Residential Aged Care’5 provides details supporting each of the following principles:
1. Consumers' physical and mental needs at the end of life are assessed and recognised 2. Consumers, families and carers are involved in end of life planning and decision-making 3. Consumers receive equitable and timely access to appropriate end of life care within aged care facilities
4. End of life care is holistic, integrated and delivered by appropriately trained and skilled staff 5. The end of life care needs of consumers with dementia or cognitive impairment are understood and met within residential aged care 6. Consumers, families and carers are treated with dignity and respect 7. Consumers have their spiritual, cultural and psychosocial needs respected and fulfilled 8. Families, carers, staff and residents are supported in bereavement5
After assessing a resident’s palliative care needs:
Next Actions:
The resident’s care plan should be updated to reflect their palliative care needs. The four domains identified in the Assessing Palliative Care Needs section of the toolkit are also used in this section to highlight how to meet the palliative care needs of the resident and their family.
Watch the ELDAC Assess Palliative Care Needs educational video will help you to describe the importance of person-centred and holistic assessment; identify the four domains of wellbeing used in palliative care assessment and recognise the importance of care planning to support end of life care.
This section has a range of links that provide a range of information on common symptoms:
Difficulty Sleeping
Fatigue
Appetite Problems
Oral Care
Nausea
Bowel Problems
Dyspnoea (Breathing Problems)
Skin and Wound Care
Pain
Delirium
Dementia Care
Anxiety
Depression
The Palliative Care Needs Assessment Guidance (pdf 2.3MB) has information on all four domains and considers the whole family as the unit of care. There are suggestions on the approach to take; identification of symptoms and concerns with example prompts for the assessor; and suggested actions to take.
When assessing a person with life-limiting illness it is important to understand their concerns in relation to home, family and community; and to identify risk in relation to their independence and social functioning.
palliAGED has downloadable Practice Tips on Talking about Dying for Nurses (pdf 315kb) and Careworkers; (pdf 454kb) Continuity of Care for Nurses (pdf 268kb) and Careworkers; (pdf 437kb) and Case Conferences for Nurses (pdf 340kb) and Careworkers. (pdf 431kb)
The Palliative Care Needs Assessment Guidance (pdf 2.3MB) has information on all four domains including suggestions on identifying psychological and emotion issues residents may have. People with life limiting conditions frequently have psychological concerns. In order to identify these concerns, it is essential that the assessor is proactive in asking about emotional and psychological issues. Concerns may include:
Knowing and understanding the resident’s cultural beliefs will help careworkers be more sensitive to the resident’s and family’s needs and traditions. Careworkers will be better able to show respect, which helps provide good end-of-life care.
palliAGED has downloadable Practice Tips on Spiritual Care for Nurses (pdf 270kb) and Careworkers. (pdf 340kb)
The Agency for Clinical Innovation has a video the place of spiritual care at the end of life.
Palliative Care Australia has a comprehensive website devoted to palliative care resources. Some of these include:
The PCA website has a section called ‘Understanding Palliative Care’ that includes information on:
The PCA website has a ‘Support and Services’ section that offers information on:
The Department of Health has a website devoted to palliative care and end of life care. There is a short video called “Talking about Palliative Care” featuring people from diverse cultures chatting about end of life care. While not specifically featuring people living in residential aged care it might be useful to show other staff or families.
CareSearch has also a webpage about residents wanting to talk with someone – in terms of finding the right person, professional help or support group.
The PalliAGED website has collated a comprehensive list of resources for the family on palliative care and end of life needs including topics on:
There is a webpage on communication at the end of life that has resources to assist in communicating with families, especially at such as emotional time.
Page updated 07 December 2023