Emergency Planning and Management

What we know

A palliative care emergency is a sudden and life-threatening change in a person’s condition. Handovers of care are particularly important to reduce risk of receiving inappropriate treatment. Planning ahead for possible emergencies is good practice and can improve the quality and safety of care. Documentation of care preferences or the nomination of a substitute decision-maker can help to ensure that a person receives care in line with their wishes.

Go to Evidence Summary

What can I do?

Suggest that the family consider advance care planning. Resources from Advance Care Planning Australia can help guide discussions and decisions around advance care planning.

Make available the fact sheet about advance care planning for individuals (200kb pdf) and the factsheet for substitute decision-makers (200kb pdf) so that people in your care and their families can prepare for the future and document choices or preferences.

Use this form (928kb pdf) to help you prepare and conduct a conversation with a GP when you are concerned about a resident’s health.

Remember that extended care paramedics and nurse practitioners may be able to provide care that could avoid a hospital admission.

When people decide to be cared for at home, ensure that they have a care plan which includes what to do in an emergency.

Advance care planning information can be uploaded to My Health Record.

Ensure that the Advance Care Plan (ACP) or Advance Care Directive (ACD) can be found quickly and easily. Make sure the contact details are up to date for the next-of-kin, the substitute decision-maker and the person to contact in case of an emergency; these may not be the same person.

When someone is transferred in an emergency, make sure that the current care plan and documents such as an ACD goes with them.

Support the person and their carers by letting them know about the Emergency care plan (481kb pdf) and other resources on Planning for emergencies from Carer Gateway.

Suggest that the person, their carers and family fill-out and print the palliAGED Emergency contacts form (84kb pdf) and leave it somewhere easy to find such as on the fridge.

Tell the person, their carers and family about the My Aged Care information on service continuity during an emergency event.

After a health emergency or a hospital admission, review the care plan. A family meeting may be helpful. palliAGED forms can help with the organisation of a family meeting.

Use palliAGED Symptoms and Medicines pages for anticipatory prescribing and prescribing guidance for older people in the terminal phase.

Use palliAGEDgp and palliAGEDnurse apps to plan care across different stages of care of the older person approaching death.

palliAGED Tip sheets

Tips for Careworkers:
Recognising Deterioration

Tips for Nurses:
Recognising Deterioration

What can I learn?

Take the opportunity to update your skills on symptom management for respiratory distress, pain and gastrointestinal issues. Explore the options for free self-directed learning available online that are listed on Palliative Care eLearning on the CareSearch website.

Complete the End-of-Life Essentials online learning modules and check out their practice resources for doctors, nurses and allied health professionals to improve the quality and safety of end-of-life care in hospitals.

Check out Advance Care Planning Australia Learning for online learning modules for all those interested in learning more about advance care planning.

Read:

Reymond L, Cooper K, Parker D, Chapman M. End-of-life care: Proactive clinical management of older Australians in the community. Australian Family Physician. 2016;45:76-8
Burkett E, Scott I. CARE-PACT: A new paradigm of care for acutely unwell residents in aged care facilities.
Australian Family Physician. 2015;44(4):204-9. The policy on end-of-life and palliative care in the Emergency Department (557kb pdf) - Australasian College for Emergency Medicine (ACEM).
The factsheet about advance care planning for care workers (202kb pdf).

What can my organisation do?

Recommend palliAGEDnurse app for nurses working in residential, community or primary care looking after people with a life-limiting illness or approaching the end of their life.

Recommend the palliAGEDgp app for GPs who are caring for older palliative patients living at home or in residential care.

Upskill staff to manage symptoms that might otherwise indicate the need for an acute care admission.

Prepare staff and services for the recognition of impeding death to avoid sense of emergency/panic if unprepared.

Consider developing an emergency care pathway that might reduce the need for acute care admissions. Review after-hours emergency procedures.

Prepare staff to be comfortable and confident with communication at a time of an emergency, that they know how to pass on 'bad news' and are sensitive to how people may receive 'bad news'. VITALtalk resources can be helpful.

Train staff to introduce discussion around advance care planning and offer contact details of people who can provide assistance in completing the paperwork.

Ensure there is a process of integrating an Advance Care Plan (ACP) or Advance Care Directive (ACD) into notes/records and the goals of care with a process for review.

Make sure that a copy of the ACD is readily available in notes or records; an electronic version may assist accessibility by various people and organisations which provide care.

Page updated 07 July 2021