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For GPs

For some clinicians, individuals requiring palliative care can be few and far between. This section lists resources that support GPs in understanding the available services and structures that assist in the provision of good palliative care. These can help in clinical decision-making and in managing care in different settings.

For guidance on management of symptoms in an individual with palliative care needs, see Symptoms and Medicines.

A Palliative Approach

A palliative approach is a type of palliative care. A palliative approach recognises that death is inevitable and focuses on the care rather than cure of a person with multiple chronic conditions, frailty and/or a life-threatening or life-limiting illness. The goal of a palliative approach is to improve or optimise a person’s level of comfort and function and to offer appropriate treatment for any distressing symptoms. A palliative approach addresses a person’s psychological, spiritual, social, emotional and cultural needs. Families are welcomed as partners in this approach.

A palliative approach recognises that for older people with multiple chronic conditions, frailty and/or a life-threatening or life-limiting illness, that this is often the last chapter of their life the length of which is unknown.

The Palliative Approach Toolkit (The PA Toolkit)

The PA Toolkit is a comprehensive, step-by-step guide to implementing a palliative approach in residential aged care facilities (RACFs). A factsheet What is a Palliative Approach? (64kb pdf) is available.

Therapeutic Guidelines – Palliative Care (subscription required)

An overview of palliative care

Affirming Life – What is a palliative approach?

This guide may be helpful for family and friends of residents.
 

Recognising Change

Supportive and Palliative Care Indicators Tool (SPICT)

SPICT is used to help us identify people at risk of deteriorating and dying with one or multiple advanced illnesses for holistic, palliative care needs assessment and care planning.
SPICT4ALL is a second version of SPICT with less ‘medical’ language that can be used by patients, family carers and staff working in health

Over 75 assessment

This health assessment allows a detailed investigation of an older person's health. It can be a prompt to consider the future of the person.

The Surprise Question

This simple and feasible screening test may identify patients palliative care needs: Would I be surprised if this patient died in the next 12 months?

Framework Approach

This describes a three stage approach to care after identification of possible palliative care needs with the Surprise Question. Stages include: advance care planning, case conferencing and terminal management.


Communication

How to discuss prognosis and end-of-life issues 

Examples of phrases that can be used in discussing prognosis (142kb pdf) developed for the End Of Life Essentials Project.

Communication

CareSearch GP resource on communicating with patients, families and colleagues.

 

Planning for the Future

Advance Care Planning Australia

This is a comprehensive site that provides information for health professionals and links to state and territory legislation.

ACPTalk

ACPTalk provides informational support for health professionals conducting advance care planning with people from different religious and cultural backgrounds.

End of Life Law in Australia

This site provides access to information about Australian laws relating to death, dying and decision-making at the end of life.

 

Providing Care

Symptoms and Medicines 

A new section in the Evidence Centre is a gateway to fast and reliable access to evidence to inform your clinical practice. It provides an overview of common symptoms and how to manage medications. There are links to other useful Australian resources 

Working with Families

The support and care of families as well as patients is a crucial part of end-of-life care. CareSearch has a set of printable patient and family resources.
Therapeutic Guidelines has a section on support for families and carers in palliative care.

Case conferences

Case Conferences can help to review and clarify goals of care and treatment options. Including patients and carers where possible is valuable.

Recognising Dying

Recognising dying is the first step in terminal care management.
The palliAGED app (available as an app or online) includes a section Recognising Dying
The Residential Aged Care End of Life Care Pathway (RAC EoLCP) is a care plan that guides the provision of good quality end-of-life (terminal) care in residential aged care.
 

Terminal Care

Deterioration in the last days of life (terminal phase) can be rapid and can be a time of great change in the patient’s condition. Understanding when death is imminent allows the clinical team and the family to prepare, ensuring that the patient is comfortable.
The following symptoms, commonly seen in the terminal phase, are treated in more depth in the section Symptoms and Medicines

Home Deaths

Planning for a Home Death is a checklist of things to consider and discuss from CareSearch.

Terminal Prescribing

This document from caring at home and ANZSPM summarises prescribing advice for the community. (136kb pdf)
 

Bereavement

As an illness progresses, a person, his or her family, carers and friends may experience intense feelings of grief associated with losses and the relationship changes that unfold. Following a death, most bereaved people do not require counselling or specialist support. General practitioners can help by acknowledging the experience of grief or bereavement and providing reassurance. A GP may identify people experiencing more severe or prolonged grief reactions and assist them to receive psychological support.

Resources for GPs Resources for the Bereaved  

Helpful Resources

  • For GPs, CareSearch
    Resource that addresses the reality of palliative care for GPs
  • Therapeutic Guidelines: Palliative Care
    Comprehensive overview of clinical and care issues and guidance.
  • palliAGEDgp app (available as an app or online) 
    palliAGED GP iconSmartphone app for GPs to support care of older palliative patients living at home or in residential care. It includes terminal prescribing advice.
  • Primary Health Networks (PHNs)
    Primary Health Networks are supporting primary care to improve care delivery and care coordination in the community. There six agreed priorities for targeted work by PHNs and aged care is one of these. Contact your local PHN to find out what resources they have available for aged care and end-of-life care.
     

Useful Videos

These videos were produced for the palliAGED or the Decision Assist projects  Page updated 21 September 2018