Guidelines for a Palliative Approach in Residential Aged Care

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121. Saunders, C. M. (1998). Foreword. In D. Doyle, G. W. C. Hanks, & N. MacDonald (Eds.), Oxford textbook of palliative medicine (2nd ed.) (pp. v–viii). New York: Oxford University Press. 122. Greenstreet, W. (2001). The concept of total pain: a focused patient care study. British Journal of Nursing, 10, (19), 1248–1255. 123. Bernabi, R., Gambassi, G., Lapane, K., Landi, P., Gatsonis, C., Dunlop, R., Lipsitz, L., Steel, K. & Mor, V. (1998). Management of pain in elderly patients with cancer [erratum appears in JAMA 1999 Jan 13, 281(2):136]. Journal of American Medical Association, 279, (23), 1877–1882. 124. Teno, J. M., Bird, C. & Mor, V. (1999). The prevalence of treatment of pain in United States nursing homes. Providence, RI: Center for Gerontology and Health Care Research, Brown Medical School. 125. McClean, W. J. & Higginbotham, N. H. (2002). Prevalence of pain among nursing home residents in rural New South Wales. Medical Journal of Australia, 177, 17–20. 126. Miller, S. C., Mor, V., Wu, N., Gozalo, P. & Lapane, K. (2002). Does receipt of hospice care in nursing homes improve management of pain at the end of life? Journal of the American Geriatrics Society, 50, (3), 507–515. 127. Sloman, R., Ahern, M., Wright, A. & Brown, L. (2001). Nurses’ knowledge of pain in the elderly. Journal of Pain & Symptom Management, 21, (4), 317–322. 128. Gloth, F. M., III. (2001). Pain management in older adults: prevention and treatment. Journal of the American Geriatrics Society, 49, (2), 188–199. 129. Health Care Committee. (1994). Medication for the older person. Retrieved December 10, 2003, from the National Health & Medical Research Council (NHMRC) Web site: http://www.nhmrc.gov.au 130. American Geriatrics Society. (2002). The management of persistent pain in older persons. Journal of the American Geriatrics Society, 50, (Suppl. 6), S205–224. 131. Lockhart-Wood, K. (2001). Nurse-doctor collaboration in cancer pain management. International Journal of Palliative Nursing, 7, (1), 6–16. 132. Manfredi, P., Breuer, B., Wallenstein, S., Stegmann, M., Bottomley, G. & Libow, L. (2003). Opioid treatment for agitation in patients with advanced dementia. International Journal of Geriatric Psychiatry, 18, (8), 700–705. 133. Sullivan, K., Johnston, L., Colyer, C., Beale, J., Willis, J., Harrison, J. & Welsh, K. (2003). Indigenous palliative care needs study — final report. Canberra, Australian Capital Territory: Commonwealth of Australia. 134. McCaffery, M. & Pasero, C. (1999). Pain: clinical manual (2nd ed.). St Louis, MO: Mosby, Inc. 135. Mercadante, S., Radbruch, L., Caraceni, A., Cherny, N., Kaasa, S., Nauck, F., Ripamonti, C. & De Conno, F. (2002). Episodic (breakthrough) pain: consensus conference of an expert working group of the European Association for Palliative Care. Cancer, 94, (3), 832–839. Guidelines for a Palliative Approach in Residential Aged Care 193
136. Horgas, A. L. & Dunn, K. (2001). Pain in nursing home residents: comparison of residents’ self-report and nursing assistants’ perceptions. Journal of Geriatric Nursing, 27, (3), 44–53. 137. Kamel, H. K., Phlavan, M., Malekgoudarzi, B., Gogel, P. & Morley, J. E. (2001). Utilizing pain assessment scales increases the frequency of diagnosing pain among elderly nursing home residents. Journal of Pain & Symptom Management, 21, (6), 450–455. 138. Gloth, F. M., Scheve, A. A., Stober, C. V., Chow, S. & Prosser, J. (2001). The Functional Pain Scale: reliability, validity, and responsiveness in an elderly population. Journal of the American Medical Directors Association, 2, (3), 110–114. 139. Closs, S. J., Barr, B., Briggs, M., Cash, K. & Seers, K. (2004). A comparison of five pain assessment scales for nursing home residents with varying degrees of cognitive impairment. Journal of Pain & Symptom Management, 27, (3), 196–205. 140. Joanna Briggs Institute. (2001). Pain assessment tools. Retrieved July 10, 2002, from Joanna Briggs Institute for Evidence Based Nursing & Midwifery Web site: http://www.joannabriggs.edu.au 141. Cleeland, C. S., Gonin, R., Hatfield, A. K., Edmonson, J. H., Blum, R. H., Stewart, J. A. & Pandya, K. J. (1994). Pain and its treatment in outpatients with metastatic cancer. New England Journal of Medicine, 330, (9), 592–596. 142. Wynne, C. F., Ling, S. M. & Remsburg, R. (2000). Comparison of pain assessment instruments in cognitively intact and cognitively impaired nursing home residents. Geriatric Nursing, 21, (1), 20–23. 143. Pasero, N. (1997). Pain control: using the Faces scale to assess pain. American Journal of Nursing, 97, (7), 19–20. 144. Melding, P. S. (2002). Can we improve pain management in nursing homes? Medical Journal of Australia, 177, (1), 5–6. 145. Du Pen, S. L., Du Pen, A. R., Polissar, N., Hansberry, J., Kraybill, B. M., Stillman, M., Panke, J., Everly, R. & Syrjala, K. (1999). Implementing guidelines for cancer pain management: results of a randomised controlled clinical trial. Journal of Clinical Oncology, 17, (1), 361–370. 146. Australian Medicines Handbook Pty. Ltd. (2002). Australian Medicines Handbook (Vol. 2002). Melrose Park, South Australia: Author. 147. Australian Medicines Handbook Pty. Ltd. (2003). Australian Medicines Handbook Drug Choice Companion: Aged Care. Melrose Park, South Australia: Author. 148. World Health Organization. (1996). Cancer pain relief: a guide to opioid availability. Retrieved August 18, 2002, from World Health Organization Web site: http://www.who.int 149. Zech, D. F. J., Grond, S., Lynch, J., Hertel, D. & Lehmann, K. A. (1995). Validation of World Health Organization guidelines for cancer pain relief: a 10-year prospective study. Pain, 63, (1), 65–76. 194 Guidelines for a Palliative Approach in Residential Aged Care
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Guidelines for a Palliative Approac
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NHMRC APPROVAL These guidelines wer
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4 ADVANCE CARE PLANNING 55 4.1 Impl
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16 MANAGEMENT’S ROLE IN IMPLEMENT
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17 Ann and Mr Wells’ family Helpi
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IMPORTANT NOTICE On 8 December 2005
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achieved for these guidelines from
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facets of a palliative approach are
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Additional levels of evidence The N
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Guidelines Ref No. Evidence level A
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Guidelines Ref No. Evidence Cachexi
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Guidelines Ref No. Evidence Anxiety
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Guidelines Ref No. Evidence 70. Und
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1.1.1 Aims The aims of the systemat
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Table 1: Search terms Terms Aborigi
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1.1.5 Exclusion Criteria Although t
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in the methodology that may invalid
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To ensure the reliability of the re
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1.2.2 Methodology When the first re
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1.4.2 Method When feedback was requ
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Several Working Party members conve
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or disagreed with each stakeholder
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All the feedback received was colla
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CHAPTER 2 A PALLIATIVE APPROACH A s
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• Profound weakness • Trouble s
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• Has the resident had a recent d
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in the RACF rather than transferrin
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palliative care teams is more appro
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or ageing progression (see Table 4)
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Table 7: A practical model of socia
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Vignette 2: Robert’s story Robert
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CHAPTER 4 ADVANCE CARE PLANNING Car
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efore discussing the advance care p
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• A change in their health status
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CHAPTER 5 ADVANCED DEMENTIA Advance
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A study was conducted to investigat
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5.3.2 Acute illness One study found
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Vignette 5: Anna’s story Anna was
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(see Fainsinger, Miller and Bruera
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Dame Cicely Saunders first describe
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Table 8: Common myths about pain ma
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6.2.4 Breakthrough pain The term
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Pain can lead to behavioural change
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Vignette 7: Mrs Harris’ story Mrs
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examined the addition of paracetamo
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provision and storage of drugs, whe
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successfully tested predominantly w
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The reasons for malnutrition in old
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The diets of residents should also
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To assist in such a discussion, a d
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appear until dehydration is far adv
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Guideline: Hydration 24. Recommenda
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6.7 NAUSEA AND VOMITING Nausea is t
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• Do you have any problem control
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6.9.1 Assessment A thorough oral as
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6.10 SKIN INTEGRITY The major skin
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Wounds can occur in residents for a
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Brocklehurst and colleagues (1999)
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medication treatment along with non
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• CAM therapies may be culturally
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word games, the present day, and fa
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CHAPTER 7 PSYCHOLOGICAL SUPPORT A r
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7.1.1 Death statements and depressi
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the factor structure of the CSDD. I
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7.2.2 Management Non-pharmacologica
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Table 17: Distinguishing delirium f
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is recognised that in many rural an
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important [305] (Level QE). Familie
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8.4 FAMILY INVOLVEMENT The role of
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CHAPTER 9 SOCIAL SUPPORT, INTIMACY
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Rather than denying the existence o
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9.2.2 Management Imaginative progra
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Guideline: Social Support Social Su
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Page 160 and 161: CHAPTER 11 CULTURAL ISSUES Australi
Page 162 and 163: 11.2 Assessment The best approach t
Page 164 and 165: CHAPTER 12 SPIRITUAL SUPPORT Dein a
Page 166 and 167: Vignette 13: Jack’s story Jack wa
Page 168: Guideline: Spiritual Support 68. A
Page 171 and 172: interpersonal and leadership skills
Page 174 and 175: CHAPTER 14 END-OF-LIFE (TERMINAL) C
Page 176 and 177: mood (61%), constipation (59%) and
Page 178 and 179: e relevant, and may even worsen sym
Page 180 and 181: Treatment involves changes in posit
Page 182 and 183: 14.5 PREPARING FOR IMMINENT DEATH
Page 184: education of the aged care team and
Page 187 and 188: Table 21: Grief, loss and bereaveme
Page 189 and 190: • excessively avoiding tasks remi
Page 191 and 192: Vignette 18: Reflections When provi
Page 193 and 194: may have been able to contribute to
Page 196 and 197: CHAPTER 16 Management’s role in i
Page 198 and 199: REFERENCES 1. World Health Organiza
Page 200 and 201: 31. Hanson, L. C., Danis, M. & Garr
Page 202 and 203: 60. World Health Organization Quali
Page 204 and 205: 89. McCarthy, M., Addington-Hall, J
Page 208 and 209: 150. Sindrup, S. H. & Jensen, T. S.
Page 210 and 211: 177. Berry, E. M. & Marcus, E.-L. (
Page 212 and 213: 208. Robinson, S. B. & Rosher, R. B
Page 214 and 215: 237. Brocklehurst, J., Dickinson, E
Page 216 and 217: 265. Barraclough, J. (1997). ABC of
Page 218 and 219: 295. Brown, T. M. & Boyle, M. F. (2
Page 220 and 221: 328. Kristjanson, L. J., Leis, A.,
Page 222 and 223: 360. McGrath, P., Vun, M. & McLeod,
Page 224 and 225: 392. Saunders, C. M. & Baines, M. J
Page 226 and 227: 424. Rawlings, D. & Glynn, T. (2002
Page 228 and 229: Glossary acetaminophen Acetaminophe
Page 230 and 231: coordinator of volunteers coping A
Page 232 and 233: geropsychologist A geropsychologist
Page 234 and 235: opioids Opioid is a specific term u
Page 236: specialised palliative team A speci
Page 239 and 240: Ms Wendy Shiels Dr Jane Sims Dr Chr
Page 242: APPENDIX B The Australian Governmen
Page 245 and 246: APRAC GUIDELINES: EVIDENCE EVALUATI
Page 247 and 248: APRAC GUIDELINES: EVIDENCE EVALUATI
Page 250 and 251: APPENDIX F: Summary of the frequenc
Page 252: APPENDIX G: An example of how the g
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APPENDIX I: Resource list PALLIATIV
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Psychological Challenge Depression
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APPENDIX J: Examples of advance dir
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Schedule 1 MEDICAL POWER OF ATTORNE
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APPENDIX K An example of a Genogram
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INDEX Abbey Pain Scale 64, 71, 78 A
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evidence levels 5, 6, 20, 21, 22 ev
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andomized controlled trials 5, 21 R
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Palliative Care Australia PO Box 24
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