K. Glaetzer

Recognising the need for palliative care in aged care

This definition clarifies the essence of palliative care, but further consideration is required to identify how this theory can be applied in practice. Perhaps the most difficult context in which to identify the need for palliative care is in the aged care setting. Residents of residential aged care facilities (RACFs) require accurate initial assessment and regular reappraisal to determine the appropriateness of a palliative approach to care. It is of utmost importance that this appraisal should be based on individual needs, rather than being diagnosis specific or prognosis based.

What general practitioners said about the palliative care case conference in residential aged care: An Australian perspective. Part 1

Abstract Objective To examine the views of general practitioners on providing a palliative approach in residential aged care and in particular their experiences with the palliative care case conference. Background The national project sought to implement and evaluate a comprehensive evidence-based palliative approach in residential aged care. Methods A purposive sample of 11 general practitioners (GPs) across Western Australia (2), South Australia (6), and Queensland (3) participated in face-to-face, semi-structured interviews. Qualitative content analysis was used to generate the core categories. Results The evaluation by the GPs of the palliative care case conference in residential aged care is explained through three core themes: people, place, and performance. Understanding what GPs say about the people involved and the place in which they work, namely the residential aged care facility, can purposefully inform practice and policy. What GPs say about the performance or ‘doing’ a palliative care case conference is provided in Part II of this two part series. Conclusion The views of GPs, on providing a palliative approach in residential aged care facilitates, offer a critical reflection on current practices and systems.

Breaking down the silos: Collaboration delivering an efficient and effective response to palliative care emergencies

Abstract Objectives The objective of this article is to explore the introduction of a rapid response team as outlined in the South Australian Palliative Care Services Plan 2009–2016. The Plan identifies this service as being provided by nurse practitioners. This workforce is not yet fully developed so a partnership model utilizing the extended care paramedic has been explored for the provision of out-of-hours emergency care to palliative patients. Methods A working group was established under the auspices of the Palliative Care Clinical Network to progress the partnership model of care. Key stakeholders from SA Ambulance, the Royal District Nursing Society, Flinders University, and Specialist Palliative Care Services (SPCS) made up the steering committee. Satisfaction telephone surveys were conducted following the trial phase to assess the community acceptance of this model. Results Data were collected from across the metropolitan area of Adelaide. There were 40 paramedic visits during the 118 days of the trial, which equates to 10 days per month. About 78.5% of the patients requiring this service were registered with a SPCS. Satisfaction from patients, caregivers, and the extended care paramedics was high. Conclusions This partnership model has enabled an emergency after-hours service to be provided between the SPCS and the ambulance service. This unlikely alliance has been very well received by patients and family members wishing to remain at home. Early data reveals that 90% of unnecessary and unwanted admissions to hospitals have been avoided in the palliative care population.