As modern healthcare has been successful in keeping more people alive, with illness, for longer, the nature of hospitalisation is shifting from cure to care, including managing the end of life. There are more older people in our population; people are living longer; and more people are living with chronic disease, dementia and increasing frailty.
Many people experience disease that results in increased disability often with recurrent hospital admissions and progressive decline over time. Our role is to highlight increasing chronic disease, to shift our focus from prolonging life to maximising quality of life and providing appropriate care to patients and their families.
Palliative care is an approach that improves the quality of life of patients and their families with life-threatening illnesses through the prevention of suffering including physical, psychological and spiritual suffering.
A palliative approach to care is relevant and will benefit any older person who has an illness or condition that is likely to affect how long they will live or if they are becoming frail.
This topic gives an overview of palliative care and recommends actions that we and our organisations can take, in addition to health service policy and procedures, to provide quality care to older patients at the end of their life.
Palliative approach focuses on improving quality of life
Palliative care aims to improve the quality of life of patients who have a terminal illness and their families.
Palliative care and ageing
Palliative care is for patients with a life-threatening or terminal illness. It can be sought by and offered to people with a variety of conditions.
Responding to the need for palliative care
When a patient needs palliative care, the approach should be introduced to the patient and their family in a clear and sensitive way.
Managing physical symptoms during palliative care
People who need palliative care may have physical symptoms impacting on their quality of life and these need to be addressed.
Managing personal, emotional, cultural and spiritual needs in palliative care
People receiving palliative care often experience emotional symptoms, and have cultural, personal and spiritual needs.
Palliative care - grief and loss
Palliative care extends to caring for a person and their family and carers after death.
Further information - palliative care
Educational and information resources available on palliative care and older people in hospital.
All public and private hospitals are required to be accredited to the Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. The primary aims of the standards are to protect the public from harm and to improve the quality of health service provision. Assessment to the second edition of the NSQHS Standards commenced in January 2019. The second edition comprises eight standards that provide a nationally consistent statement about the level of care consumers can expect from health services.
The Comprehensive Care Standard (Standard 5) aims to ensure that patients receive comprehensive health care that meets their individual needs, and considers the impact of their health issues on their life and wellbeing. It also aims to ensure that risks of harm for patients during health care are prevented and managed through targeted strategies. These include integrating patient care processes to identify patient needs and identifying actions related to falls, pressure injuries, nutrition, mental health, cognitive impairment and end-of-life care.
Information is presented in the Older People in Hospital learning topics that complements Standard 5 and other NSQHS Standards including the; Partnering with Consumers Standard (Standard 2), Medication Safety Standard (Standard 4), Communicating for Safety Standard (Standard 6) and Recognising and Responding to Acute Deterioration (Standard 8).
Reviewed 10 November 2021