Guidelines for a Palliative Approach in Residential Aged Care

Several Working Party members convened focus groups with NCISN members in each state
and territory to ensure that consultation regarding the draft Guidelines was nation-wide,
representative and generalisible. Participants (N = 176) represented a broad cross section
of aged care and palliative care health professionals including, general practitioners (GPs),
palliative care medical specialists, aged care and palliative care nurses, and allied health
professionals. Academics with relevant expertise in the area, representatives of various peak
bodies, coordinators of volunteers, and consumers were also included in the focus groups.
The Guidelines were sent out to participants one week prior to the focus group to provide them
with sufficient time to consider their response. The 104 Guidelines were formatted to allow
focus group participants to respond to each guideline in one of three ways; 1) supported, 2)
supported with revisions or 3) not supported. The Guidelines were presented in this format at
all of the focus groups. (See Appendix G for an example of how the Guidelines were presented.)
Each participant received a hard copy of the Guidelines well in advance of the meeting, with
the invitation to provide written comments to be discussed at the focus group meeting.
Because of the number of guidelines to be reviewed it was decided by the project working party to
divide the task and involve two focus groups in every state and territory. (Assessment, co-morbidities
and physical symptoms were discussed in both groups because participants felt that this area was
crucial to ensuring a palliative approach was appropriate to the context of RACFs.)
The first focus groups discussed:
• assessment, co-morbidities and physical symptoms,
• advance care planning,
• family support,
• bereavement,
• spirituality, and
• volunteers.
The second focus group discussed:
• assessment, co-morbidities and physical symptoms,
• documentation of social relationships,
• attitudes to palliative care,
• psychosocial care, and
• culture.
A brief overview of the development of the Guidelines, the literature review and the grading of
evidence was provided by the facilitator to participants to begin the focus group. The way in
which rural, remote, cultural and Indigenous issues were being covered on a national level was
also highlighted.
Each focus group then worked through their requisite guideline subjects with every guideline
presented on overhead to facilitate discussion. As well as having the ‘background questions’ in
mind, the groups were asked to consider (a) any gaps in the Guidelines, (b) any recommendations
arising out of the Guidelines and (c) additional suggestions for evidence/literature.
30 Guidelines for a Palliative Approach in Residential Aged Care