Guidelines for a Palliative Approach in Residential Aged Care

in the RACF rather than transferring them to an acute setting. [6,47] These decisions are usually
based on the resident’s familiarity with the aged care team and the facility, adequate care already
being provided in the RACF, a request from the resident, their family or the GP, or a lack of
hospice beds. [6,47]
A palliative approach can usually be provided in an RACF. [6] This offers benefits to the resident
and family through consistency and continuity of care. In some instances there may be a need
for intermittent specialised palliative support when residents have complex symptoms or the
aged care team requires additional support. However, this consultation can often occur while
the resident remains in the RACF.
Guideline:
Where can a palliative approach be provided?
Ref No.
Evidence level
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.
6, 23 QE
2.4 WHO CAN PROVIDE A PALLIATIVE APPROACH?
A palliative approach is best provided by an effective multidisciplinary team [48,49] (Level QE)
[50]
(Level III-2). An effective team recognises and acknowledges that team members are likely
to have different perspectives about a palliative approach, yet team members are able to clarify
and address the reasons for these differences. When a multidisciplinary team uses this approach,
their job satisfaction improves as does the quality of care that is provided to residents and their
families [48] . A team approach to care planning also facilitates the aged care team in providing
residents with highly individualised care, which allows for the discussion of advance care plans
that address prognosis, emotional preparation , and appropriate use of medical treatments
(including the potential benefits and disadvantages of treatment decisions) [49] (Level QE).
2.4.1 What is a ‘multidisciplinary team’?
A multidisciplinary team is a group consisting of three or more people from different disciplines
who collaborate in making decisions about all aspects of diagnosis, treatment and care of
residents and their families [48,49] (Level QE). Effective multidisciplinary teams can provide
support and symptom control to improve the quality of both living and dying for residents
and their families through a palliative approach. This multidisciplinary approach is critical to
the success of a palliative approach because the wide variety of forms of distress experienced by
residents and their families requires a broad range of skills [49] (Level QE).
The multidisciplinary team focuses its efforts on addressing the problems that are of most
concern to the resident [49] (Level QE). Barriers to appropriate treatment, such as confusion over
pain medications, whether a facility has access to requisite medications, and uncertainty about
the benefits of treatment, can also be addressed.
Guidelines for a Palliative Approach in Residential Aged Care 43