When the time comes, will you be ready to leave? Will you be of sound enough mind to tell others how you’d like to go?
The truth is, few of us are. Just 3 per cent of Australians over 65 have a statutory advance care directive in place. Mortality is, after all, a hard thing to confront – the impulse is to delay and deny, prevaricate and evade. But, for the sake of ourselves and those who care for us (in both senses of the word), it is critical to be prepared for the final act and exit.
But this is a responsibility we shouldn’t bear alone.
New, groundbreaking research out of Australia has offered a proactive, evidence-based mechanism for aged care homes to enable staff to better facilitate quality of death and dying for their residents. Key to their model is specialist palliative care intervention, implemented through what they term ‘Needs Rounds’.
Chaired by a specialist palliative care clinician, these Rounds comprise monthly triage meetings with care home staff, where over the course of an hour they discuss 10 residents at risk of dying without a plan in place and who are experiencing complex symptoms.
Goals of care are then articulated, and plans are formulated. Nurses, nursing aides, activities coordinators and managers attend.
The study found these Needs Rounds improved staff confidence and capability, making them more proactive about attending to and meeting the care needs of residents in their final months of life.
Rates of care planning also increased, “with care home staff actively engaging families around discussing anticipatory care and anticipatory medicines”.
Published in the Journal of the American Geriatrics Society, involving researchers from the University of Canberra, the Australian National University, UTS Sydney, the Australian Catholic University and Calvary Public Hospital, the trial has since received increased funding from the ACT government, with plans to roll it out across the state. For their work, the team received the 2019 National Palliative Care Award for Innovation.
Despite the high rate of mortality in aged care homes, care of dying residents is largely “suboptimal” in these places, the researchers judged. Approaches are inconsistent, staff are underequipped, and steps towards sustainable change often falter. Over the last year, the real-life consequences of this deficiency have been writ large in the frequently devastating testimonies submitted to the Royal Commission into Aged Care Quality and Safety.
See the original story from Aged Care Insite HERE
Picture from Palliative Care Australia: Liz Forbat, Juliane Samara, Jane Koerner, Nikki Johnston and Wai-Man Liu at the Palliative Care Awards, Receiving the award from Rohan Greenland (CEO Palliaitvie Care Australia) and Dr Jane Fischer (Board Chair of Palliative Care Australia) Not pictured: co-authors Michael Chapman and Lawrence Lam. Source: Palliative Care Australia