About palliative care
Palliative care is person- and family-centred care provided for a person with an active, progressive, and advanced disease. The primary goal of palliative care is to optimise the quality of life and to address physical, emotional, spiritual, and social symptoms and issues. [1] All health professionals who provide care to people living with a life-limiting illness, their families and carers need to have core competencies in the provision of palliative care. People with more complex needs should be able to access specialist palliative care services. Care can be provided in many different settings – in hospitals, in a person’s home or in residential aged care. [2]
The importance of palliative care as part of health care and as a societal responsibility has been recognised. The World Health Organization regards palliative care as a human right [3] and the World Health Assembly unanimously passed a resolution to strengthen palliative care as a component of comprehensive care throughout the life course [4].
Palliative care and aged care
Sixty-six per cent of deaths registered in Australia in 2020 were among people aged 75 or over (60% for males and 73% for females). The median age at death was 79 years for males and 85 years for females. [6] A detailed analysis of 116,481 Australians who died in 2010–11 aged at least 65 years showed that 80% of these people had used aged care in the 8 years before death, and three-fifths were aged care clients when they died. [7] Aged care is involved in providing care to older Australians who are in the last years and months of life as well as providing care for people in the last days of their life. Indeed, the tone and intent of the final report of the Royal Commission into Quality and Safety in Aged Care saw that palliative and end-of-life care, like dementia care, needs to be considered as core business for aged care providers.
Palliative care provision in the context of older age and aged care services needs to acknowledge specific issues and contexts. This can include multimorbidity, disease trajectories, equity, and diversity considerations, cognitive impairment and the prevalence of dementia, workforce capability, family and social networks, mobility issues, and location of care. [8-10] This highlights the need active engagement around goal setting and advance care planning.
Bereavement is also an important consideration in palliative care. Grief can be experienced before death by older people and their families. Even when the person has lived a long life and death is expected, families and friends can experience grief and loss as can the staff who have been providing care to clients and residents. [11]