Guidelines for a Palliative Approach in Residential Aged Care

4 ADVANCE CARE PLANNING 55
4.1 Implementing advance care planning 55
4.2 Advance care planning for residents with advanced dementia 57
4.3 Legal considerations and documentation 57
4.4 The right to refuse food 59
5 ADVANCED DEMENTIA 61
5.1 How prevalent is dementia? 61
5.2 Advanced dementia and a palliative approach 61
5.3 Assessment 62
5.4 Management 65
5.5 Family support 66
6 PHYSICAL SYMPTOM ASSESSMENT AND MANAGEMENT 69
6.1 Symptom assessment 69
6.2 Pain management 71
6.3 Management of fatigue 85
6.4 Nutrition and hydration 87
6.5 Anorexia 96
6.6 Cachexia 96
6.7 Nausea and vomiting 98
6.8 Dysphagia 99
6.9 Mouth care 101
6.10 Skin integrity 104
6.11 Bowel care 106
6.12 Dyspnoea 109
6.13 Complementary therapies 111
7 PSYCHOLOGICAL SUPPORT 117
7.1 Depression 118
7.2 Anxiety 122
7.3 Confusion 123
7.4 Delirium 124
7.5 Dementia (psychological aspects) 126
8 FAMILY SUPPORT 129
8.1 What is a family? 129
8.2 Families and a palliative approach 129
8.3 Documenting family relationships 131
8.4 Family involvement 132
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Guidelines for a Palliative Approach in Residential Aged Care