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What it is: Continuity of care has three main parts:
Why it matters: Continuity of care helps care providers to be aware of a person’s preferences and care needs. It also helps with the smooth coordination of a person’s care. It is particularly important for the care of a person who may be at the end of life. It also helps care providers to have the information they need so that the person’s choices are respected.
What I need to know: Continuity of care can:
Ask your supervisor about any documents that should accompany a person when transferred between care settings.
Talk clearly with the family, carers, nurses and management to ensure you and others are aware of any new goals of care.
Report to nursing/supervisory staff any changes that you notice in the person or requests made by the older person or their family.
Ask your supervisor about the SPICT4ALL tool (299kb pdf). This helps you to identify people who are declining in health and might benefit from better supportive and palliative care.
How do I report to nursing/supervisory staff any changes that I notice or any questions that family members may have?
See related palliAGED Practice Tip Sheets:
Advance Care Planning
End-of-Life Care Pathways
Talking within the Aged Care Team
For references and the latest version of all the Tip Sheets visit www.palliaged.com.au/Practice-Centre/For-Careworkers
CareSearch is funded by the Australian Government Department of Health and Aged Care. Updated July 2022