Terminology- About ELDAC
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Terminology

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Aboriginal or Torres Strait Islander

A person of Aboriginal and/or Torres Strait Islander descent who identifies as an Aboriginal and/or Torres Strait Islander.

Activities of daily living

A set of activities necessary for daily living that include feeding, personal hygiene, dressing, movement and transferring. [1]

Activities of daily living domain

A domain under the Aged Care Funding Instrument which assesses a person’s capacity in relation to nutrition, mobility, personal hygiene, toileting, and continence. [2]

Advance care directive

An Advance Care Directive is a legal document that allows a person to make their future healthcare preferences known if they were to lose their capacity to make decisions. It will only operate when a person no longer has decision-making capacity. The law and forms for Advance Care Directives are different in each state and territory and the terminology used may vary as well (e.g. Advance Directives, Advance Health Directives). [1]

Advance care plan

A plan that states preferences about health and personal care, and preferred health outcomes. An advance care planning discussion will often result in an advance care plan. Plans should be made on the person’s behalf and prepared from the person’s perspective to guide decisions about care. [3]

Advance care planning

The process of preparing for likely scenarios near the end of life that usually includes assessment of, and discussion about, a person’s understanding of their medical condition and prognosis, values, preferences, and personal and family resources. Advance care planning supports a person in communicating their wishes about their end of life. [3]

Aged Care Assessment Team

A team of medical and allied health professionals employed by State and Territory Governments who assess older people for eligibility and level of subsidised aged care services. [2]

Aged Care Diversity Framework

An Australian Government strategy aimed at ensuring aged care services meet the needs of people from diverse backgrounds. [2]

Aged Care Funding Instrument

The instrument is used to measure the level of care each resident need, based on activities of daily living, resident’s behaviour, and complex health care. Outcomes are then used to allocate Australian Government subsidy to residential aged care providers to care for the residents. [4]

Aged Care Principles

A series of legislative instruments made under the Aged Care Act 1997 that set out the rules for government-funded aged care, including in relation to funding, allocation of places, approval of providers, quality standards, user rights, complaints and sanctions. They include the Accountability Principles 2014, the Quality of Care Principles 2014, and the User Rights Principles 2014. [2]

Aged Care Quality Standards

A set of standards for the provision of aged care that apply to all Australian Government subsidised aged care services. The standards are set out in Schedule 2 to the Quality of Care Principles 2014. [2]

Approved Aged Care provider

An organisation approved under Part 7A of the Aged Care Quality and Safety Commission Act 2018 to receive subsidies from the Australian Government for providing home care, residential aged care or flexible care services, or a combination of these. [5]

Assistive technology

Devices and technologies that maintain or improve an older person’s functioning to facilitate safety, independence, social inclusion and enhance overall wellbeing. Examples include walking frames, shower chairs, pressure-relieving mattresses, personal and location monitoring technology or specialised software and hardware that increase hearing, vision, communication, social interaction, or cognitive stimulation capacities. [2]

Australian National Aged Care Classification (AN-ACC)

A proposed new assessment and funding model for residential aged care developed by the Australian Health Services Research Institute (AHSRI) at the University of Wollongong for the Australian Department of Health as part of the Resource Utilisation and Classification Study. [2]

Benchmark

A standard of performance that all services are measured against. [1]

Best practice

When the diagnosis, treatment or care provided is based on the best available evidence, which is used to achieve the best possible outcomes for patients. [5]

Best-practice guidelines

A set of recommended actions that are developed using the best available evidence. They provide clinicians with evidence-informed recommendations that support clinical practice, and guide clinician and patient decisions about appropriate health care in specific clinical practice settings and circumstances. [5]

Care finders

A proposed workforce of personal advisers to older people, their families and carers that work face-to-face. Care finders will assist people seeking aged care to understand, identify and access care and supports in their local area, including following up and checking in when people commence using aged care. [2]

Care pathway

A complex intervention that supports mutual decision-making and organisation of care processes for a well-defined group of patients during a well-defined period. [5]

Care management

The day-to-day coordination of care, which includes creating a care plan (in conjunction with the older person and their carer), managing and organising services, monitoring the services delivered, reviewing the care plan as needs change and referring the older person for reassessment when their needs change. [2]

Care plan

A plan that outlines a person’s care needs, the types of services they will receive to meet those needs, who will provide the services and when. It is developed by the person’s service providers in consultation with them as part of the care planning process. [3]

Care planning

The process of identifying a person’s needs and enabling care providers to access this information and work with the person to determine services that best meet their needs. The care planning cycle involves an assessment of the needs of the service user; documentation of those needs; developing strategies/support/treatment to meet those needs; discussing these strategies with the service user; choice of preferred options by the service user in collaboration with the service provider; documentation of the plan of care for each need, and regular review to assess management of the person’s needs. [3]

Carer

A person who provides personal care, support and assistance to another individual who needs it because they have a disability, medical condition (including a terminal or chronic illness) or mental illness, or they are frail and aged. An individual is not a carer merely because they are a spouse, de facto partner, parent, child, other relative or guardian of an individual, or live with an individual who requires care. A person is not considered a carer if they are paid, a volunteer for an organisation or caring as part of a training or education program. [6]

Clinical communication

The exchange of information about a person’s care that occurs between treating clinicians, patients, carers and families, and other members of a multidisciplinary team. Communication can be through several different channels, including face-to-face meetings, telephone, written notes or other documentation, and electronic means. [7]

Clinician

A healthcare provider, trained as a health professional, including registered and non-registered practitioners. Clinicians may provide care within a health service organisation as an employee, a contractor or a credentialed healthcare provider, or under other working arrangements. They include nurses, midwives, medical practitioners, allied health practitioners, technicians, scientists and other clinicians who provide health care, and students who provide health care under supervision. [7]

Digital Health

The electronic management of health information. This includes using technology to collect and share a person’s health information. It can be as simple as a person wearing a device to record how much exercise they do each day, to health care providers sharing clinical notes about an individual.

Dying

The terminal phase of life, where death is imminent and likely to occur within hours or days, or occasionally weeks. This is sometimes referred to as ‘actively dying’. [7]

End-of-life

The period when a patient is living with, and impaired by, a fatal condition, even if the trajectory is ambiguous or unknown. This period may be years in the case of patients with chronic or malignant disease, or very brief in the case of patients who suffer acute and unexpected illnesses or events, such as sepsis, stroke, or trauma. [8]

End-of-life care

Includes physical, spiritual, and psychosocial assessment, care and treatment delivered by health professionals and ancillary staff. It also includes the support of families and carers, and care of the patient’s body after their death. [9]

Family

Those who are closest to the patient in knowledge, care and affection. This may include the biological family, the family of acquisition (related by marriage or contract), and the family and friends of choice. [10]

Goals of care

The aims for a patient’s medical treatment, as agreed between the patient, family, carers and healthcare team. Goals of care will change over time, particularly as the patient enters the terminal phase. Medical goals of care may include attempted cure of a reversible condition, a trial of treatment to assess reversibility of a condition, treatment of deteriorating symptoms, or the primary aim of ensuring comfort for a dying patient. The patient’s goals of care may also include non-medical goals e.g. returning home or reaching a milestone, such as participating in a family event.

Health Literacy

Health literacy is described as the capacity of individuals to obtain, process, and understand basic health information and their ability to make decisions and act in ways that enhance or protect their health in daily life.

Healthcare Record

Includes a record of the patient’s medical history, treatment notes, observations, correspondence, investigations, test results, photographs, prescription records and medication charts for an episode of care. [5]

Home Care

Care consisting of a package of personal care services and other personal assistance provided to a person who is not being provided with residential care. [2]

Interdisciplinary team

A team of providers who work together to develop and implement a plan of care. Membership depends on the services required to identify and address the expectations and needs of the patient, carers and family. An interdisciplinary team might typically include one or more doctors, nurses, social workers, spiritual advisers, pharmacists and personal care workers. Other disciplines may be part of the team, depending on the needs of the patient and the resources available. Hospital volunteers, patients, carers and family members may also be considered as part of the interdisciplinary team. [5]

Life-limiting illness

The term life-limiting illness is used to describe illnesses where it is expected that death will be a direct consequence of the specified illness. Such illnesses may include, but are not limited to cancer, heart disease, chronic obstructive pulmonary disease, dementia, heart failure, neurodegenerative disease, chronic liver disease and renal disease. The term person living with a life-limiting illness also incorporates the concept that people are actively living with such illnesses, often for long period of time, not simply dying. [10]

Local Health Network

A government-funded entity established by a State or Territory Government to manage a single public hospital service or a small group of public hospital services. Local Hospital Network is the term mainly used in the report and, unless otherwise indicated, is inclusive of Local Health Districts, Local Health Networks, Hospital and Health Services, and Health Services. [2]

Medication management

Practices used to manage the provision of medicines. Medication management has also been described as a cycle, pathway or system, which is complex and involves a number of different clinicians. The patient is the central focus. The system includes manufacturing, compounding, procuring, dispensing, prescribing, storing, administering, supplying and monitoring the effects of medicines. It also includes decision-making, and rules, guidelines, support tools, policies and procedures that are in place to direct the use of medicines. [7]

Medication review

A systematic assessment of medication management for an individual patient that aims to optimise the patient’s medicines and outcomes of therapy by providing a recommendation or making a change. [5]

My Aged Care

An Australian Government service providing a single entry-point to aged care. It includes a national contact centre with a single phone number, a website describing services, assessment forms and guidelines, centralised client records, and web-based portals for clients, assessors and service providers. [2]

My Health Record (formerly known as a personally controlled electronic device)

A national digital health record system containing information about individuals’ health care assessments, procedures, treatments, and consultations that is administered by the Australian Digital Health Agency. [2]

National Aged Care Mandatory Quality Indicator Program

The National Aged Care Mandatory Quality Indicator Program started on 1 July 2019. The program collects quality indicator data from residential aged care services every 3 months. Over time, this data will provide an evidence base that can be used to improve the quality of services provided to care recipients. [2]

National Safety and Quality Health Service Standards

The standards established by the Australian Commission on Safety and Quality in Health Care that apply to all health service providers in Australia, designed to protect the public from harm and improve the quality of service provision. [2]

Non-beneficial treatment

Interventions that will not be effective in treating a patient’s medical condition or improving their quality of life. Non-beneficial treatment may include interventions such as diagnostic tests, medications, artificial hydration and nutrition, intensive care, and medical or surgical procedures. Non-beneficial treatment is sometimes referred to as futile treatment, but this is not a preferred term.

Palliative care

An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. [11] It should be an integral component of all relevant global disease control and health system plans, including those relating to non-communicable diseases and universal health coverage, as well as being included in country and regional cooperation plans. [4]

The Aged Care Funding Instrument (ACFI) 12 Complex Health Care includes a complex health care procedure described as "palliative care program involving end of life care where ongoing care will involve very intensive clinical nursing and/or complex pain management in the residential care setting". [4]

All health professionals who provide care to people living with a life-limiting illness, their families and carers should have minimum core competencies in the provision of palliative care. PCA refers to this type of care that is provided by other health professionals, including GPs, as ‘palliative care’ (although it is also sometimes known as ‘generalist palliative care’). [10]

Person-centred care

An approach to the planning, delivery and evaluation of health care that is founded on mutually beneficial partnerships among clinicians and patients. Person-centred care is respectful of, and responsive to, the preferences, needs and values of patients and consumers. Key dimensions of person-centred care include respect, emotional support, physical comfort, information and communication, continuity and transition, care coordination, involvement of carers and family, and access to care. [7]

Personal care worker

An occupational title assigned to people who provide care to older people, people with disability and health care patients in a range of settings, including private homes, hospitals and residential aged care facilities. Personal care workers are not registered health practitioners. A wide variety of other titles are used to describe personal care workers, including personal care attendant, assistant in nursing, community care worker, home support worker and home care employee. [2]

Primary Health Network

An administrative health region established to deliver access to primary care services (such as general practitioners) and coordinate with local hospitals to improve the overall operational efficiency of the network. [2]

Quality improvement

The combined efforts of the workforce and others – including consumers, patients and their families, researchers, planners and educators – to make changes that will lead to better patient outcomes (health), better system performance (care) and better professional development. Quality improvement activities may be undertaken in sequence, intermittently or continually. [7]

Quality Review

A process of reviewing the quality of home care services, Commonwealth Home Support Programme services and flexible care services against the Aged Care Quality Standards. [2]

Resuscitation orders/plans

Documents completed by a doctor to outline the plan of care in relation to emergency treatment of severe clinical deterioration. Not for resuscitation (NFR) and do not attempt resuscitation (DNAR) orders relate solely and specifically to decisions to not perform cardiopulmonary resuscitation if the patient has a cardiac or respiratory arrest. In some organisations, decisions about other specific limitations of medical treatment may also be listed as part of a resuscitation plan (e.g. decisions to call a medical emergency team or transfer a patient to intensive care if they deteriorate). [5]

Shared decision-making

A consultation process in which a clinician and a patient jointly participate in making a health decision, having discussed the options, and their benefits and harms, and having considered the patient’s values, preferences and circumstances. [7]

Specialist palliative care

Services provided by clinicians who have advanced training in palliative care. The role of specialist palliative care services includes providing direct care to patients with complex palliative care needs, and providing consultation services to support, advise and educate non specialist clinicians who are providing palliative care. [10]

Substitute decision-maker

A person appointed or identified by law to make substitute decisions on behalf of a person whose decision-making capacity is impaired. Substitute decision-makers have legal authority to make these decisions; the relevant legislation varies between jurisdictions (states and territories). A document that appoints a substitute decision-maker to make health, medical, residential and other personal decisions (but not financial or legal decisions) is considered to be an advance care directive. More than one substitute decision-maker may be appointed under an advance care directive. There are three categories of substitute decision-makers:

  • substitute decision-makers chosen by the person (e.g. one or more enduring guardians appointed under a statutory advance care directive, or a nominated substitute decision-maker in a common law advance care directive)
  • substitute decision-makers assigned to the person by the law in the absence of an appointed substitute decision-maker (e.g. family member, carer or ‘person responsible’)
  • substitute decision-makers appointed for the person (e.g. a guardian appointed by a guardianship tribunal). [3]

Terminal phase

The hours, days or, occasionally, weeks when a patient’s death is imminent. This is sometimes referred to as the period when a patient is actively dying. [5]

Voluntary assisted dying

An intervention by an authorised health practitioner, either providing the person with the means to end their life or (if the person is unable to do so) ending the person’s life with the primary intent of relieving pain and/or suffering, at the person’s voluntary, repeated, and fully informed request. [12]

Workforce

All people working in a health service organisation, including clinicians and any other employed or contracted, locum, agency, student, volunteer or peer workers. The workforce can be members of the health service organisation or medical company representatives providing technical support who have assigned roles and responsibilities for care of, administration of, support of, or involvement with patients in the health service organisation. [7]

  • References
  1. Palliative Care Australia. National Palliative Care Standards, 5th edition 2018 (372kb pdf).
  2. Royal Commission into Aged Care Quality and Safety. Final report - Summary and Recommendations (4MB pdf). Canberra, 2021.
  3. The Clinical, Technical and Ethical Principal Committee of the Australian Health Minister’s Advisory Council. A National Framework for Advance Care Directives (2.28MB pdf). Canberra: AHMAC, 2011.
  4. Australian Government Department of Health. Aged Care Funding Instrument (ACFI) User Guide 2017 [Internet]. 2017 [updated 2017 Feb 28; cited 2017 May 22.]
  5. Australian Commission on Safety and Quality in Health Care. National Consensus Statement: essential elements for safe and high-quality end-of-life care [Internet]. Sydney: ACSQHC, 2015 Cited 9 July 2021.
  6. Carer Recognition Act 2010 [Accessed 16 July 2014, at www.comlaw.gov.au/Details/C2010A00123.]
  7. Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Services Standards. 2nd ed. - version 2. Sydney: ACSQJC; 2021.
  8. Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Services Standards End of Life definition (2MB pdf), 2017.
  9. Australian Institute of Health and Welfare. Australia's health 2016 (7MB pdf). Canberra; AIHW; 2016.
  10. Palliative Care Australia. Palliative Care Service Development Guidelines January 2018 (332kb pdf). Canberra: Palliative Care Australia, 2018.
  11. World Health Organization. WHO definition of palliative care [Internet]. 2020.
  12. The Australian Nursing and Midwifery Federation. Voluntary assisted dying (316kb pdf). The Australian Nursing and Midwifery Federation, 2019.

Page updated 12 July 2021