Department for Health and Wellbeing
Hospice in Residential Aged Care
Wednesday 12 October 2022
3:00pm – 3:30pm
Kate is the Clinical Lead for the End of Life Care Team within the SA Department for Health and Wellbeing. Kate has provided leadership and program management support to the jointly funded Comprehensive Palliative Care in Aged Care Measure since 2020. Prior to that she was the Clinical Director for Southern Adelaide Palliative Care Services.
Kate holds academic status with Flinders University and is a member of the Research Centre for Palliative Care Death and Dying. Her research interests are on the psychosocial aspects of care and looking at models that ensure the person dying is supported not only physically but psychologically, emotionally socially and spiritually. It is this commitment to holistic care that underpins the Hospice in the RACF model currently being piloted in 22 sites in SA.
Hospice in Residential Aged Care
The Comprehensive Palliative Care in Aged Care Measure is a joint 5-year initiative between the Commonwealth and State Governments of Australia from July 2019 to June 2024.
South Australia’s Department for Health and Wellbeing have designed a model of care to be tested within residential aged care facilities (RACFs) to improve access and support to residents at end of life.
Hospice in the RACF is a contemporary and innovative approach to supporting residents in both metropolitan Adelaide and regional South Australia.
The focus of the program will be on the development of a range of initiatives to ensure RACFs are equipped to internally provide end of life care for residents in RACFs including;
- Advance care planning,
- Escalation of care pathways,
- Specialist palliative care (SPC) in-reach support,
- Education and training,
- Personal care worker traineeships and
- Grief and bereavement support.
This pilot program is designed to ensure that residents of RACFs have good end of life care available within the RACF, regardless of diagnosis, location and life circumstances. Residents will be looked after by RACF staff who bring empathy, skills and expertise, ensuring the resident experiences competent, confident and compassionate care that is in line with the residents’ wishes as part of the advance care planning discussion. The program ensures RACF staff are supported to access skills, advice and education from specialist palliative care services.
The Hospice in the RACF program aims to demonstrate an increase in people dying in their place of choice, with a higher number of resident wishes communicated through either the non-statutory advance care plan or advance care directive, resulting in a reduction in avoidable hospital admissions.
There are 22 sites currently participating in the pilot. The Rural Support Service is project managing the sites located in regional South Australia (n=15) and Eldercare Incorporated is testing the model in metropolitan sites (n=7)
Both programs deliver the Palliative Care Needs Rounds with a focus on GP engagement, and both use clinical nurse educators to support the education needs of the aged care workforce. Eldercare has engaged Palliative Care Nurse Practitioners and is trialling the palliative care traineeship for Cert III care workers.
Both programs commenced in 2021 and early reports indicate enhanced confidence and competence in end-of-life care management at the RACF by the carer and nursing workforce. There is a separate GP engagement component within the model and GP engagement is increasing with attendance at Palliative Care Needs Rounds and dedicated education sessions. Outcomes are being monitored and reported on both by the SA evaluation team and the Commonwealth evaluation team.
Flinders University are conducting a formal evaluation which will be completed in 2023. The evaluation report will be provided to the commonwealth government and shared with stakeholders in South Australia.
NOUS are conducting the national evaluation and this will be completed in 2024.
End of Life Care is Aged Care Core Business. Joint State and Commonwealth funding has enabled the piloting of an innovative Hospice in Aged Care Pilot being undertaken in SA.