Alfred Health in partnership with Monash University has been awarded an ARIIA grant for their project ‘Emergency-Department-Initiated Palliative Care for Older People Transferred from Residential Aged Care: wrong time and place, or exactly what is needed?'
In Australia, one-third of older people living in residential aged care (RAC) are transferred to hospital in the last month of life and 20 percent of older people living in RAC will die in hospital.
The Emergency Department (ED) may not be traditionally thought of as the ideal setting for the initiation of palliative care, however early recognition of unmet palliative care needs can improve the quality of end-of-life care for patients and the experience of families. Previous studies have identified that ED clinicians may experience challenges integrating palliative care in the ED setting and palliative care services have limited involvement until a person is admitted to hospital. Further understanding of decision-making practices and experiences of ED clinicians (doctors and nurses) and consumers (older people living in RAC and their family members’) are needed to support the timely integration of palliative care into the patient journey.
Alfred Health and Monash University will trial an intervention designed to enhance recognition and response to unmet palliative care needs in older people transferred from RAC. This will support a systemic health system approach to palliative care engagement across the hospital and RAC sectors to improve end-of-life care delivery.