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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’.

Many people spend the last stages of their lives in aged care, and for that reason Palliative Care Australia believes that end-of-life care should be recognised as core business for residential aged care.  Increasingly, aged care providers are recognising the need to ensure their workforce have the necessary skills and competencies to deliver high quality end-of-life care. Yet in spite of this recognition, access to quality palliative care services is far from guaranteed in residential aged care – particularly in rural and remote areas.
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We all want the ‘best death possible’ for our loved ones and ourselves as we enter old age. So we need to ask ourselves, what are the barriers to accessing care that can support this, and will looking at the issue from a population or needs-based policy perspective help to ensure end-of-life care becomes core business for all aged care providers?

One of the statements we commonly see in research reports and in policy and service documents is a comment about an ageing population. The reality of a demographic change where people are living longer than ever before has been instrumental in driving rethinking around issues  such as retirement age, superannuation access, healthy lifestyles and supportive living environments. Living longer does not however mean living forever, and an ageing population means we also need to consider how we support older Australians as they approach death.
 

Health professionals need to know the law that governs withholding and withdrawing life-sustaining treatment. Law is not at the centre of the clinical encounter, but it is part of the regulatory framework that governs these decisions. Failure to know and follow the law puts health professionals and their patients at risk. But we know there are gaps in health professionals’ legal knowledge in this area and this is not surprising either, given how complex and difficult this field of law is.

I often hear people say that once a person enters a residential aged care facility that the caring role provided by the person’s family and friends is no longer required, and yet this couldn’t be further from the truth. Aged care staff encourage family and friends to stay actively involved in a person’s life. There are many obvious reasons why this is so necessary.

Moving homes is generally a stressful and emotional time and, for residential aged care, this can be further exacerbated by the fact that it is often in response to a crisis. Someone’s mother has been admitted to hospital after a nasty fall or the care requirements of someone’s husband has increased because their diabetes isn’t being well managed. Therefore, not only are people having to make important decisions about where they, or their loved one, is going to live, but this is generally during a time when emotions are high and various members of the family may have different opinions.