Comparison of end‐of‐life care for people living in home settings versus residential aged care facilities: A nationwide study among Australian general practitioners

2021 ◽  
Author(s):  
Jinfeng Ding ◽  
Claire E. Johnson ◽  
Kirsten Auret ◽  
Dianne Ritson ◽  
Carolyn Masarei ◽  
...  
Keyword(s):  
End Of Life ◽  
General Practitioners ◽  
End Of Life Care ◽  
Aged Care ◽  
Residential Aged Care ◽  
Life Care ◽  
Nationwide Study ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

Provision of palliative and end-of-life care in New Zealand residential aged care facilities: general practitioners' perspectives

2020 ◽  
Vol 26 (2) ◽  
pp. 124 ◽  
Author(s):  
Deborah Balmer ◽  
Rosemary Frey ◽  
Merryn Gott ◽  
Jackie Robinson ◽  
Michal Boyd
Keyword(s):  
New Zealand ◽  
End Of Life ◽  
General Practitioners ◽  
End Of Life Care ◽  
Aged Care ◽  
Residential Aged Care ◽  
Life Care ◽  
Structured Interviews ◽  
Care Facilities ◽  
Aged Care Facilities

This exploratory study examined general practitioners’ (GPs) perspectives on delivering end-of-life care in the New Zealand residential aged care context. A general inductive approach to the data collected from semi-structured interviews with 17 GPs from 15 different New Zealand general practices was taken. Findings examine: (1) GPs’ life experience; (2) the GP relationship with the facilities and provision of end-of-life care; (3) the GP interaction with families of dying residents; and (4) GP relationship with hospice. The nature of the GP relationship with the facility influenced GP involvement in end-of-life care in aged care facilities, with GPs not always able to direct a facility’s end-of-life care decisions for specific residents. GP participation in end-of-life care was constrained by GP time availability and the costs to the facilities for that time. GPs reported seldom using hospice services for residents, but did use the reputation (cachet) associated with hospice practices to provide an authoritative buffer for their end-of-life clinical decisions when talking with families and residents. GP training in end-of-life care, especially for those with dementia, was reported as ad hoc and done through informal mentoring between GPs.

A residential aged care end-of-life care pathway (RAC EoLCP) for Australian aged care facilities

2011 ◽  
Vol 35 (3) ◽  
pp. 350 ◽  
Author(s):  
Liz Reymond ◽  
Fiona J. Israel ◽  
Margaret A. Charles
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Acute Care ◽  
End Of Life Care ◽  
Care Pathway ◽  
Aged Care ◽  
Residential Aged Care ◽  
Life Care ◽  
Care Facilities ◽  
Aged Care Facilities

The objective of this study was to develop, implement and evaluate an end-of-life (terminal) care pathway and associated infrastructure suitable for Australian residential aged care facilities that improves resident and health system outcomes. The residential aged care end-of-life care pathway was developed by a multidisciplinary collaboration of government and non-government professionals and incorporated best clinical management for dying residents to guide care and increase palliative care capacity of generalist staff. Implementation included identifying and up-skilling Link Nurses to champion the pathway, networking facilities with specialist palliative care services, delivering education to generalists and commencing a Palliative Care Medication Imprest System in each facility. The primary outcome measure for evaluation was transfer to hospital; secondary measures included staff perceived changes in quality of palliative care provided and family satisfaction with care. Results indicated that the pathway, delivered within a care framework that guides provision of palliative care, resulted in improved resident outcomes and decreased inappropriate transfers to acute care settings. What is known about the topic? Residential aged care facilities (RACFs) are the hospices of today. Many RACF staff are not confident in the delivery of high quality palliative care, resulting in inappropriate transfers of dying residents to acute care facilities. Needs-based palliative care pathways are being used increasingly to direct care in a variety of healthcare environments. What does this paper add? Provides the first evidence in Australia that a residential aged care end-of-life care pathway (RAC EoLCP) improves outcomes of care for dying residents and results in fewer residents being inappropriately transferred to acute care facilities. What are the implications for practitioners? Use of the RAC EoLCP will improve resident and health system outcomes by guiding the delivery of high quality palliative care and improving the palliative care capacity of generalist health providers.

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

2011 ◽  
Vol 17 (1) ◽  
pp. 95 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Caroline Nicholson ◽  
Keith McDonald ◽  
Anne Bucetti
Keyword(s):  
Palliative Care ◽  
End Of Life Care ◽  
Aged Care ◽  
Care Staff ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Advance Care

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.

scholarly journals Perceptions of multidisciplinary case conferencing in residential aged care facilities

2009 ◽  
Vol 33 (4) ◽  
pp. 566 ◽  
Author(s):  
Elizabeth J Halcomb ◽  
Rhonda Griffiths ◽  
Bernadette M Sheperd
Keyword(s):  
General Practitioners ◽  
Ad Hoc ◽  
Health Workers ◽  
Aged Care ◽  
Residential Aged Care ◽  
Team Approach ◽  
Collaborative Culture ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

Objective: To explore the understanding about and perceptions of, multidisciplinary case conferencing in residential aged care from the perspective of residential facility staff, residents, carers and general practitioners. Methods: Focus groups and in-depth interviews were conducted with nurses, residents, carers, allied health workers and general practitioners from two residential aged care facilities during February?March 2008. Conversations were analysed using thematic analysis techniques. Results: Thematic analyses highlighted four key themes. Most notably, respondents identified a degree of confusion regarding the purpose of case conferencing and its role in resident health care. The ad hoc development of the conferencing model led to unclear role descriptions for participants that contributed to role confusion and the lack of a collaborative culture. Underpinning much of the discussion was the need for a framework to support the organisation of the conference process. Conclusions: While the process of multidisciplinary case conferencing in residential aged care has significant potential to improve resident care and health outcomes, the development of an explicit framework is required to support the effective conduct of these meetings. Key stakeholders need to be engaged to develop a team approach to conducting case conferences that facilitates the active participation of providers, residents and their carers.

Sign in / Sign up

Export Citation Format

Share Document