Transcript Palliative Aged Care Program: An integrated Model

Presented by Sallie Fredericks
Nurse Consultant
Palliative Aged Care Consultancy Service (PACCS)
Background
 50,000 Australians die each year in residential aged
care facilities.
 Palliative and end of life care should be core business
for aged care services.
(Productivity Commission 2011).
Why Focus on Palliation?
 “That people with a life-limiting illness can live until
they die in an atmosphere of care and support”.
 “There is a widespread recognition that the benefits
of palliative care are not limited to the final days and
weeks before dying”.
(Guidelines for a Palliative Approach in Residential Aged Care)
Rationale:
 Hospital admissions were common towards end of life
 Late recognition that a resident may be dying
 Discussions around death where not attended until the
resident was actively dying was common
 Family members often had to make decisions about care
when the resident was very sick.
 Symptoms were not planned for so comfort medications
were often not available
Focus:
A specialised care program focused on key areas to
implement a palliative approach to care:
 Specialist palliative care staff visiting Aged Care
Facility weekly
 Engagement with GP’s- building trust and
confidence
 Improving the attitude, knowledge and skills of
staff
 Review of the systems that were in place to guide
the palliative approach
ACTION:
 Palliative Care staff attended thorough assessments of
all residents who were approaching the terminal
phase.
 Symptoms that were commonly reviewed were pain,
anorexia, dyspnoea, cachexia, nausea and vomiting,
depression, dysphagia, mouth discomfort, bowel care
and skin care.
 Plans were then made to manage these symptoms
through liaising with GP’s and Port Kembla Palliative
Care Team if necessary
Advance Care Planning
 Case conferencing and discussions with family,
residents and General Practitioners that emphasised
and promoted the resident’s quality of life and dignity.
 Ensuring care plans are formulated that focus on the
individual symptoms of the resident.
Debunking Myths
 Found to be many misconceptions about Morphine,
Palliative Care etc.
 Education was provided to all staff on the palliative
approach and the specialised care program.
 The education focused on symptoms experienced, how
to recognise the symptoms causing distress and how to
manage them.
 Education regarding the myths and misconceptions
regarding Morphine etc. were held regularly
OUTCOMES:
 GP Satisfaction??
 Planning
 Reduction in crisis care
 Residents more comfortable
 Less residents going to hospital and dying there
reduction by 2/3Rd
 Confidence in care from residents and relatives
 Staff knowledge and “comfortability”
Questions???
Contact For PACCS
 PH: 0404110498
 E-mail: [email protected]
 www.palliativeagedcareconsultancyservice.com.au