Enhancing palliative care in rural Australia: The residential aged care setting

Mitchell, Geoffrey, Nicholson, Caroline, McDonald, Keith and Bucetti, Anne (2011) Enhancing palliative care in rural Australia: The residential aged care setting. Australian Journal of Primary Health, 17 1: 95-101. doi:10.1071/PY10054

Author Mitchell, Geoffrey
Nicholson, Caroline
McDonald, Keith
Bucetti, Anne
Title Enhancing palliative care in rural Australia: The residential aged care setting
Language of Title eng
Journal name Australian Journal of Primary Health   Check publisher's open access policy
Language of Journal Name eng
ISSN 1448-7527
Publication date 2011
Sub-type Article (original research)
DOI 10.1071/PY10054
Volume 17
Issue 1
Start page 95
End page 101
Total pages 7
Place of publication Collingwood, VIC, Australia
Publisher C S I R O Publishing
Collection year 2012
Language eng
Abstract The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.
Keyword Advance care planning
End of life care pathway
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
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Created: Fri, 09 Mar 2012, 16:11:45 EST by Shani Lamb on behalf of Discipline of General Practice