scholarly journals Identification of patients with noncancer diseases for palliative care services

2005 ◽  
Vol 3 (1) ◽  
pp. 5-14 ◽  
Author(s):  
CAROL GRBICH ◽  
IAN MADDOCKS ◽  
DEBORAH PARKER ◽  
MARGARET BROWN ◽  
EILEEN WILLIS ◽  
...  
Keyword(s):  
Palliative Care ◽  
Aged Care ◽  
Residential Aged Care ◽  
Karnofsky Performance Scale ◽  
Care Services ◽  
Aged Care Facilities ◽  
Palliative Care Services ◽  
Residential Aged Care Facilities ◽  
End Stage ◽  
Performance Scale

Objective: To identify criteria for measuring the eligibility of patients with end-stage noncancer diseases for palliative care services in Australian residential aged care facilities.Methods: No validated set if guidelines were available so five instruments were used: an adaptation of the American National Hospice Association Guidelines; a recent adaptation of the Karnofsky Performance Scale; the Modified Barthel Index; the Abbey Pain Score for assessment of people who are nonverbal and a Verbal Descriptor Scale, also for pain measurement. In addition, nutritional status and the presence of other problematic symptoms and their severity were also sought.Results: The adapted American National Hospice Association Guidelines provided an initial indicative framework and the other instruments were useful in providing confirmatory data for service eligibility and delivery.

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 Changes in the profile of Australians in 77 residential aged care facilities across New South Wales and the Australian Capital Territory

2017 ◽  
Vol 41 (6) ◽  
pp. 613 ◽  
Author(s):  
Robert Borotkanics ◽  
Cassandra Rowe ◽  
Andrew Georgiou ◽  
Heather Douglas ◽  
Meredith Makeham ◽  
...  
Keyword(s):  
Aged Care ◽  
Community Health Services ◽  
Residential Aged Care ◽  
Service Utilisation ◽  
Demographic Profile ◽  
Care Services ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Permanent Residents

Objective Government expenditure on and the number of aged care facilities in Australia have increased consistently since 1995. As a result, a range of aged care policy changes have been implemented. Data on demographics and utilisation are important in determining the effects of policy on residential aged care services. Yet, there are surprisingly few statistical summaries in the peer-reviewed literature on the profile of Australian aged care residents or trends in service utilisation. Therefore, the aim of the present study was to characterise the demographic profile and utilisation of a large cohort of residential aged care residents, including trends over a 3-year period. Methods We collected 3 years of data (2011–14) from 77 residential aged care facilities and assessed trends and differences across five demographic and three service utilisation variables. Results The median age at admission over the 3-year period remained constant at 86 years. There were statistically significant decreases in separations to home (z = 2.62, P = 0.009) and a 1.35% increase in low care admissions. Widowed females made up the majority (44.75%) of permanent residents, were the oldest and had the longest lengths of stay. One-third of permanent residents had resided in aged care for 3 years or longer. Approximately 30% of residents were not born in Australia. Aboriginal residents made up less than 1% of the studied population, were younger and had shorter stays than non-Aboriginal residents. Conclusion The analyses revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. There have been several changes in aged care policy over the decades. The analyses outlined herein illustrate how community, health services and public health data can be used to inform policy, monitor progress and assess whether intended policy has had the desired effects on aged care services. What is known about the topic? Characterisation of permanent residents and their utilisation of residential aged care facilities is poorly described in the peer-reviewed literature. Further, publicly available government reports are incomplete or characterised using incomplete methods. What does this paper add? The analyses in the present study revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. The most significant finding of the study is that one-third of permanent residents had resided in an aged care facility for ≥3 years. These findings add to the overall picture of residential aged care utilisation in Australia. What are the implications for practitioners? The analyses outlined herein illustrate how community, health services and public health data can be utilised to inform policy, monitor progress and assess whether or not intended policy has had the desired effects on aged care services.

scholarly journals Injury-Related Emergency Department Presentations Among Residential Aged Care Residents in Victoria, Australia

2021 ◽  
pp. 089826432110392
Author(s):  
Ladan Yeganeh ◽  
Lyndal Bugeja ◽  
Janneke Berecki ◽  
Adrian Laughlin ◽  
Joseph Ibrahim
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Aged Care ◽  
Population Based ◽  
Direct Access ◽  
Residential Aged Care ◽  
Care Services ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Minimum Dataset

Objective This study aimed to quantify and describe the characteristics of emergency department (ED) injury presentations and subsequent hospital admissions among residents of residential aged-care facilities (RACFs) in Victoria, Australia between 2008 and 2018. Methods This study comprised a single jurisdiction population-based study of consecutive injury-related ED presentations of RACFs residents using the Victorian Emergency Minimum Dataset (VEMD). Results The rate of ED injury presentations per 100,000 population decreased by .8% per year over 10 years ( P = .03); however, the rate per 100,000 RACF bed days increased by .6% per year ( P = .05). The proportion of presentations subsequently admitted to hospital increased 4.0% per year ( P<.0001). The majority of presentations were due to falls (82.5%), with fracture(s) being the most common injury type (34.0%). Discussion The increased rate of ED visits and hospital admissions in RACFs residents highlights the need to design specialized emergency care services and/or provide better direct access to hospital care for this vulnerable population.

scholarly journals Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention

2020 ◽  
Author(s):  
Rosemary Ann Frey ◽  
Sophia Barham ◽  
Deborah Balmer ◽  
Jackie Robinson ◽  
Michal Boyd ◽  
...  
Keyword(s):  
Palliative Care ◽  
Systems Of Care ◽  
Care Delivery ◽  
Aged Care ◽  
Residential Aged Care ◽  
Structured Interviews ◽  
Palliative Care Education ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Bereaved Family

Abstract Background : The supportive hospice aged residential exchange (SHARE) is a new model of palliative care education that has been designed for residential aged care. The goal of SHARE is to help clinical staff improve palliative care within residential aged care facilities and to improve specialist palliative care nurses' knowledge and skill to care for frail older people. Method : The experiences of 18 bereaved families concerning the palliative care journey (both at the start and finish of a one-year implementation of SHARE) were explored using semi-structured interviews. Results: Three themes were important to bereaved families’ experience: communication with staff, systems of care, and hospice involvement. Sub-themes indicating changes in these three components of care between the start and finish of SHARE was identified. A fourth theme highlighted challenges (relationship with GP, staff shortages and turnover) that continued across SHARE. Conclusion : Findings indicated that SHARE benefited families (improved communication and support) through the end of life journey of their relatives, but challenges remained.

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