Guidelines for a Palliative Approach in Residential Aged Care

Summary of Guidelines
The following table provides a summary of the guidelines with their corresponding level/s of
evidence as presented in this document. To understand the context of the guidelines, readers are
strongly urged to review the appropriate chapter.
Guidelines Ref No. Evidence
level
A PALLIATIVE APPROACH
When should a palliative approach be implemented?
1. Methods used to identify survival time, such as physicians’ clinical
predictions, have limitations in accuracy and precision resulting in
overestimating survival. Therefore, relying only on these methods to
determine when to start a palliative approach is not recommended. Aged
care team members need to be aware of this tendency to overestimate
survival, to reduce residents’ and families’ potential distress.
2. Attention to residents’ transition from active curative care to palliative care
(with comfort care and symptom management) requires that aged care team
members provide the resident and their families with sufficient information
about the transition process to facilitate decision making. This provision of
information can reduce residents’ and families’ concerns and increase their
satisfaction regarding the appropriateness of a palliative approach.
Where can a palliative approach be provided?
3. A palliative approach can be provided in the resident’s familiar
surrounding if adequately skilled care is available, which reduces the need
for transfer to an acute care setting; thereby, avoiding potential distress to
the resident and his/her family.
Who can provide a palliative approach?
38 IV
24, 35 QE
6, 23 QE
4. A palliative approach is best provided by an effective multidisciplinary team. 50 III-2
DIGNITY AND QUALITY OF LIFE
5. Factors that contribute to a person’s sense of dignity are a sense of
control, strengthened relationships with loved ones, the capacity to
communicate, recognising friends and family members, being continent,
adequate pain and symptom management, and avoiding inappropriate
prolongation of dying. These factors are addressed by the aged care team
member when a palliative approach is implemented, thus enhancing the
resident’s dignity and his / her quality of life.
6. The provision of dignity-maintaining care can facilitate a more hopeful outlook
for the resident; thus reducing the resident’s desire for a hastened death.
58
57
13
63
64
III-3
IV
QE
IV
QE
Guidelines for a Palliative Approach in Residential Aged Care