Guidelines for a Palliative Approach in Residential Aged Care

word games, the present day, and famous faces. The focus of these sessions was to promote
information processing rather than to prompt recall of factual knowledge. The authors
concluded that:
• Cognitive stimulation therapy groups improved cognitive function and quality of life for
people with dementia;
• The results compared favourably with trials of drugs for dementia (i.e. acetylcholinesterase
inhibitors);
• Cognitive stimulation therapies can be used in diverse settings; and
• Cognitive stimulation therapies are enjoyable for people with dementia, and the use of this
type of cognitive training does not lead to adverse reactions such as frustration, as some
studies previously indicated.
Although this RCT provides promising results for residents with cognitive impairment, the
merits of such an approach with residents requiring a palliative approach were not considered
and, therefore, further research is required.
The Australian Pain Society (2004) [94] has developed guidelines relating to pain management.
These guidelines advocate principles regarding the use of CAM therapies. These principles are
reproduced here, with some adaptations, due to their clarity: [94]
• For safety reasons, members of the aged care team must always be informed before a
CAM therapy is used (for example, St John’s wort interacts with numerous prescription
medications). This principle also facilitates a comprehensive care plan to be developed based
on the needs of each resident;
• To reduce the risk of possible assault claims, clear approval from the resident, whether
cognitively or communication impaired, bedridden or fully capable, is essential before a
CAM therapy is used on the recommendation of family, friends, staff or doctors;
• Residents who are interested in any CAM therapy should be fully informed about its safety
and effectiveness;
• CAM therapists should be carefully selected so that the resident has confidence in their
credentials and qualifications; and
• It is advisable to check with private health insurers to determine whether a CAM therapy
is covered.
CAM therapies may be beneficial for some residents, depending on their symptoms,
culture, and beliefs about the use of such therapies. There is some evidence to support the
use of a limited number of CAM therapies for pain management, symptom alleviation and
improvement in quality of life. However further studies, particularly focusing on palliative care
and RACFs, are still required.
114 Guidelines for a Palliative Approach in Residential Aged Care