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Palliative Care

The population of Australia is ageing and while improvements in health care have extended life expectancy, there are increasing numbers of Australians who are approaching the end of their life. Australian Institute of Health and Welfare (AIHW) data indicates that the national number of registered deaths is rising and is indicative of Australia's growing ageing population. Australian Bureau of Statistics (ABS) data shows that age specific death rates begin to increase for males around 55-59 years and for females around 60-64 years and then increase steadily. [1] The proportion of older deaths in residential aged care and in the community [2] is increasing highlighting the need to ensure appropriate care for older Australian at the end of their lives.

Palliative care is care that helps people live their life as fully and as comfortably as possible when living with a life-limiting or terminal illness. Palliative care identifies and treats symptoms which may be physical, emotional, spiritual or social. [3]

Palliative care is for people of any age who have been told that they have a serious illness that cannot be cured. Palliative care assists people with illnesses such as cancer, motor neurone disease and end-stage kidney or lung disease to manage symptoms and improve quality of life. [4] Palliative care provision in the context of older age needs to consider some specific issues including multiple clinical diagnoses that require a variety of treatments; confusion, dementia, and/or communication difficulties may be present; and living and care arrangements. [5] Therefore a palliative approach to care may be useful across the illness and ageing trajectory and not just the terminal phase. [6,7]

Many different health professionals can provide palliative care. Most people will be cared for by the generalist health providers. Specialist palliative care teams provide direct care for those with complex care needs. This could be in a hospice or palliative care ward. Specialist teams also support other health professionals working in the community or in hospitals to care for their patients as they approach the end of their lives. A needs based approach underpins referral to specialist palliative care provision. [8]

References

  1. Australian Bureau of Statistics. Deaths, Australia 2014 [Internet]. 2015 [cited 2017 May 5]; ABS cat. no. 3302.0.
  2. Australian Institute of Health and Welfare. Use of aged care services before death [Internet]. 2015 [cited 2017 May 5]; AIHW cat. no. CSI 21.
  3. Palliative Care Australia (PCA). What is palliative care [Internet]. 2017 [cited 2017 May 5].
  4. Siouta N, van Beek K, van der Eerden ME, Preston N, Hasselaar JG, Hughes S, et al. integrated palliative care in Europe: a qualitative systematic literature review of empirically-tested models in cancer and chronic disease. BMC Palliat Care. 2016 Jul 8;15:56.
  5. May P, Garrido MM, Cassel JB, Kelley AS, Meier DE, Normand C, et al. Palliative care teams’ cost-saving effect is larger for cancer patients with higher numbers of comorbidities. Health Aff (Millwood). 2016 Jan;35(1):44-53.
  6. Sawatzky R, Porterfield P, Lee J, Dixon D, Lounsbury K, Pesut B, et al. Conceptual foundations of a palliative approach: a knowledge synthesis. BMC Palliat Care. 2016 Jan 15;15:5.
  7. Guideline Adaptation Committee. Clinical practice guidelines and principles of care for people with dementia (1.01MB pdf). Sydney: Guideline Adaptation Committee; 2016.
  8. Palliative Care Australia (PCA). Palliative Care Service Development Guidelines (340kb pdf). Canberra: PCA; 2018 Jan.


Page updated 21 June 2018