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It’s long been recognised that access to high quality palliative care in Australia is variable. Many Australians face difficulties in receiving palliative care due to factors such as system fragmentation, gaps in service provision, geographic scarcity of services or health professionals, access barriers for vulnerable populations and those living in residential aged care facilities, system navigation issues, low confidence of health workers in providing care to those living with a life limiting condition and limited community understanding of what palliative care is.

In health care the role of evidence in decision making is recognised by health care practitioners and providers, and relates to understanding the balance between the potential benefits and harms of any practice, treatment or intervention. Dr Katrina Erny-Albrecht of CareSearch discusses the importance of independent, critical appraisal and synthesis of evidence into reliable, practical guidance for recipients and providers of care.

The pattern of disease, dying and death has changed dramatically in Australia over the last century. In Australia alone almost 160,000 people die every year. Of these at least 120,000 are expected deaths, meaning that access to palliative care could be of great benefit to both the individuals and their families. But ensuring access to quality palliative care for all who need it is not without its challenges. This is why a group of researchers sought funding from National Health and Medical Research Council (NHMRC) for the Centre of Research Excellence in End-of-Life Care (CRE-ELC).

In my role managing two aged care homes in Melbourne, I have come across a number of challenges which needed to be overcome. I took over one home four and a half years ago and the second 18 months ago, discovering the same basic issues in each home; after the first time, the issues were relatively easy to change. Staff were fractured in the sense that departments did not necessarily rely on each other and work together, and knowledge of clinical issues was only handed over to clinical staff, not to the whole home (not an unusual happening). My idea of sharing with all staff was greeted with a degree of scepticism at first, but staff embraced it quite quickly and then started to discuss things across different departments.

For this discussion, aged care refers to the additional care required for an older person needing regular health professional input either in the community or in an aged care home.

Palliative care is, according to the WHO (World Health Organisation), ‘an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual’.