Guidelines for a Palliative Approach in Residential Aged Care

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APPENDIX I: Resource list PALLIATIVE CARE SERVICES National Office of Palliative Care Australia Suite 2, 37 Geils Court DEAKIN ACT 2600 (02) 6232 4433 pcainc@pallcare.org.au www.pallcare.org.au AGED CARE SERVICES Aged and Community Services Australia Level One, 36 Albert Road South Melbourne VIC 3205 (03) 9686 3460 info@agedcare.org.au Australian Nursing Homes and Extended Care Association (ANHECA) Limited Level 1, 25 Napier Close Deakin ACT 2600 (02) 6285 2615 office@anheca.com.au www.anheca.com.au PUBLICATIONS Palliative Care Commonwealth of Australia. (2000). National palliative care strategy. A national framework for palliative care service development. Retrieved August 28, 2002, from the Australian Government Department of Health & Ageing Web site: http://www.mentalhealth.gov.au/programs/palliative/strategy.htm O’Connor, M., & Aranda, S. (2003). Palliative care nursing: A guide to practice (2nd ed.). Melbourne, VIC: Ausmed Publications, www.ausmed.com.au. Palliative Care Australia (2004). Palliative care national directory 2004: palliative care services and hospices in Australia, www.pallcare.org.au. Bereavement risk Aranda, S., & Milne, D. (2000). Guidelines for the assessment of bereavement risk in family members of people receiving palliative care. Melbourne: Centre for Palliative Care. Multicultural Die-Trill, M. & Holland, J.C. (1993). Cross-cultural differences in the care of patients with cancer: a review. General Hospital Psychiatry, 15(1), 21–30. Hall, P., Stone, G., & Fiset, V.J. (1998). Palliative care: How can we meet the needs of our multicultural communities? Journal of Palliative Care, 14(2), 46–49. McNamara, B., Martin, K., Waddell, C., & Yuen, K. (1997). Palliative care in a multicultural society: perceptions of health care professionals. Palliative Medicine, 11(5), 359–67. Guidelines for a Palliative Approach in Residential Aged Care 243
Spiritual Hermann, C.P. (2001). Spiritual needs of dying patients: a qualitative study. Oncology Nursing Forum, 28(1), 67–72. Hume, S. K. (1991). Support in a time of need. The team approach at Mercy Medical Hospice addresses medical, emotional, and spiritual needs. Health Progress, 72(7), 40–5, 54. Thomson, J.E. (2000). The place of spiritual wellbeing in hospice patient’s overall quality of life. Hospice Journal, 15(2), 13–27. Resources for both palliative care and aged care facilities Hockley, J. & Clark, D. (Eds.) (2002). Palliative care for older people in care homes. Buckingham, UK: Open University Press (enquiries@openup.co.uk, www.openup.co.uk). Paris, M., & McLeod, A. (1999). Consider the options: end stage clinical care for chronic degenerative disorders. Resthaven Incorporated (PO Box 327, Unley SA 5061, (08) 8373 0211). Indigenous Sullivan, K., Johnston, L., Colyer, C., Beale, J.,Willis, J., Harrison, J. & Welsh, K. (2003). Indigenous palliative care needs study — final report. Canberra, ACT: Commonwealth of Australia. Willis, J. (1999). Dying in country: implications of culture in the delivery of palliative care in Indigenous Australian communities. Anthropology & Medicine, 6(3), 423–35. Multicultural Palliative Care Australia. (1999). Multicultural palliative care guidelines. (Suite 2, 37 Geils Court, Deakin ACT 2600, (02) 6232 4433, www.pallcare.org.au) Crawley, L.M., Marshall, P.A., Lo, B., & Koenig, B.A. (2002) Strategies for culturally effective end-of-life care. Annals of Internal Medicine, 136, 673–79. Jewish customs and practices, contact Mrs Vera Link, Vera_link@hotmail.com. Volunteering Volunteering Australia. (2001). National standards for involving volunteers in not for profit organisation (2nd ed.). Author. (Suite 2, Level 3, 11 Queens Road, Melbourne VIC 3004, (03) 9820 4100, www. volunteeringaustralia.org, volaus@volunteeringaustralia.org) Resources specific to aged care facilities Outside looking in: A resource kit for aged care facilities. Carers Victoria (Level 5, 130 Little Collins Street, Melbourne VIC 3000, (03) 9650 9966) Ethics Code of ethical standards for Catholic health and aged care services in Australia. Catholic Health Australia (PO Box 330, Deakin West ACT 2600). Department of Health and Ageing (2001) Code of ethics and guide to ethical conduct for residential aged care. CommonwealthAvailable from www.health.gov.au. Fleming, J.I., Tonti-Filippini, N. & Pike, G.K. (2001) An ethics handbook for aged care facilities. Adelaide, SA: South Australia Network for Research on Ageing. Nutrition Bartl, R., & Bunney. C. (2004). Best practice food and nutrition manual for aged care facilities. Nutrition Department, Central Coast Health (PO Box 361, Gosford NSW 2250, (02) 4320 3691). Pain management Australian Pain Society. (2004). APS Residential aged care pain management guidelines. Crows Nest, New South Wales: Australian Pain Society. 244 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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include lack of information about t
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CHAPTER 11 CULTURAL ISSUES Australi
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11.2 Assessment The best approach t
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CHAPTER 12 SPIRITUAL SUPPORT Dein a
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Vignette 13: Jack’s story Jack wa
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Guideline: Spiritual Support 68. A
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interpersonal and leadership skills
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CHAPTER 14 END-OF-LIFE (TERMINAL) C
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mood (61%), constipation (59%) and
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e relevant, and may even worsen sym
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Treatment involves changes in posit
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14.5 PREPARING FOR IMMINENT DEATH
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education of the aged care team and
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Table 21: Grief, loss and bereaveme
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• excessively avoiding tasks remi
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Vignette 18: Reflections When provi
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may have been able to contribute to
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CHAPTER 16 Management’s role in i
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REFERENCES 1. World Health Organiza
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31. Hanson, L. C., Danis, M. & Garr
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60. World Health Organization Quali
Page 204 and 205: 89. McCarthy, M., Addington-Hall, J
Page 206 and 207: 121. Saunders, C. M. (1998). Forewo
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
Page 258 and 259: Psychological Challenge Depression
Page 260 and 261: APPENDIX J: Examples of advance dir
Page 262 and 263: Schedule 1 MEDICAL POWER OF ATTORNE
Page 264: APPENDIX K An example of a Genogram
Page 268 and 269: INDEX Abbey Pain Scale 64, 71, 78 A
Page 270 and 271: evidence levels 5, 6, 20, 21, 22 ev
Page 272: andomized controlled trials 5, 21 R
Page 275 and 276: Palliative Care Australia PO Box 24
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