400837 Health And Socio Political Issues In Aged Care



Discuss the “palliative approach” to residential aged care. Then, discuss and evaluate how this approach might be applied in practice.

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Your discussion should include policies about residential aged care policy and the end funding model.

This discussion will discuss what an oaliatrve is and what systems are best to promote a Palliative Approach in Residential Aged Care at a National and International Level.

This will include a discussion about the challenges in providing palliative and hospice care in residential elderly care.

It should also discuss the funding of aged services as well as how this affects palliative medicine in aged care.

You should write an essay that includes an introduction and conclusion. Subheadngs might help you structure this longer essay.

Contemporary literature can be used to defy the terms “panelme approach” and “end of Life Care”.

Ethical perspective: Discuss advanced care directives paricularly

Consider the potential for funding reSidental care faCilities by using a palliative strategy to help end of life care.

With reference to literature, critique these ideas and approaches

Answer to Question: 400837 Health And Socio Political Issues In Aged Care


Palliative Care services are meant to improve the quality of life for patients with progressive disease.

Palliative care can be provided for patients who have no hope of remission.

According to the World Health Organisation, palliative is care provided to patients who have a life-threatening illness. This care is meant to improve quality of life by providing pain relief, prevention, diagnosis and treatment.

Palliative Care can be provided in several settings, such as paediatric services and neonatal units.

Specialist services are available from community-based services as well as inpatient and hospice care. (Parker et. al., 2013,).

The paper examines the Palliative approach to end of life care in residential aged homes at a national, as well international level.

This paper is designed to explain the concept and show how it can be combined with evidence that supports its application in policy.

This paper will provide a critique of the palliative approach’s implementation in practice for older people.

The paper examines policies around advance directives and funding models for residential aged home care.

It also addresses issues related to palliative healthcare and its impacts.

Palliative Care

Palliative, which derives its name form the Latin palliatus, means “relieving or curing”. (Zimmermann et. al. 2014).

Palliative is care that is given to patients who are suffering from an active or progressive condition and have no chance of getting care.

It is for patients suffering from advanced cancers and other non-malignant conditions. These include heart disease, dementias, motor neurone diseases, respiratory disease, renal failure, Parkinson’s Disease, muscular dystrophy, and heart failure.

This approach affirms life, it gives pain relief and relieves other distressing symptoms.

The dying process is treated as normal, and no efforts are made to prolong or hasten death (Parker and colleagues, 2013).

In some countries, there is a distinction made between hospice care or palliative.

Both approaches follow a similar philosophy.

The US uses a distinction. The two aspects differ in how they pay for services and where they are offered.

Both the hospice and the nonhospice team of palliative services in the UK offer care to people with any stage or illness. The care is not curable.

However, there are many health professionals who do not specialize in palliative care but still follow the principles of palliative medicine in their everyday work (Free 2018).

Australia considers palliative approaches important and a core competency of all health professionals (Broad, et al. 2013, 2013).

Culture is a key component of an individual’s journey in life.

Spirituality and culture play an important role in someone’s lives.

In many cases, it has been proven that health beliefs can be tied to the spiritual and religious affiliations of an individual along with their cultural background (Mazanec und Panke (2015)).

Palliative medicine combines cultural, spiritual, and psychological elements to enable a patient to live a full life until their death.

Palliative treatment also takes into account the family’s wishes and needs (Free, 2018).

End of Life Care

End-of-life care is provided to patients in their final months or years.

It is for patients who are near death such as those with advanced cancers, strokes, dementia or those who have had a tragic event in their lives.

Care is intended to provide dignity to death and allow the dying person to live to the fullest extent possible.

Patients’ wishes, preferences and family perspectives are considered while providing care.

These patients are entitled to high quality care. Patients are free to express their desires to receive care at their home, hospice, care home, or hospital, depending on their needs and preferences (Rosenwax and al. 2016).

End-of-life care can be provided by nurses, doctors in hospitals, community staff, general practitioners, counsellors as well as social workers, physiotherapists, occupational and occupational therapists.

If the patient who is near the end of their life receives home care, it is the responsibility of the general practioners to provide the care.

Palliative Care is provided in cases of distressing or severe symptoms that are not curable.

This method is used to comfort patients (Virdun et.al. 2015).

Residential Aged Care: A Palliative Approach to End-of-Life Care

At both national and international level, residential aged care facilities are designed in a way that allows medical professionals to view the patient’s files and allows the palliative method to be implemented as quickly as possible.

Residential aged care facilities support the palliative method, which allows for an open communication system between patients and the aged care team (Tuckett (2015)).

These facilities guarantee that skilled staff can be hired to provide quality care at all times.

It is important to have the right skill mix to prevent patients from being moved to acute care. Also, it can reduce distress for both the patient and their family.

The aged care staff’s role is to learn about and continue professional development in the field of palliative care.

The palliative strategy in aged care facilities includes several elements.

It incorporates the principles dignity, autonomy, respect, comfort, and respect.

It also involves open communication and honesty with the older adults regarding the current situation and the possible treatment options.

The palliative health team must make every effort to offer older adults the best possible evidence-based treatment options.

Palliative care for the end of life involves pain relief and the effective management of distressing feelings.

It is about providing access to the people they desire, and it also considers cultural and spiritual preferences (Mazanec und Panke (2015)).

The palliative team provides support and care for patients suffering from life-limiting illness.

Free, 2018. The goal is to not hasten or delay the end of life.

Spiritual considerations can include the provision of resources such as pastoral workers, meditative and aromatherapy music, or objects of personal importance, as well photos of loved ones that can offer comfort and relief (Lopez Sierra & Rodriguez Sanchez, 2015).

Parker et. al.

The medical practioners direct care for elderly persons with life-limiting illness in residential aged facilities.

Practioners’ role is to prescribe medication or treatments and to make the best treatment decisions.

This process is dominated by these practioners.

The difference between palliative or acute care should be made clear to the practioner.

The medical practioner must ensure that both the terminally ill and the chronically ill receive palliative services and care.

It is crucial to provide care that is compassionate and based on comfort, rather than on the cure.

However, the appropriate care does NOT mean sending the older patient into hospital. Further, Tuckett et al.

(2014) suggested that palliative therapy should avoid distressing the patient, regardless of whether the symptoms can be treated.

Some hospital visits may be necessary for comfort.

More emphasis is placed on the relief of distressing symptoms with positive approach and consideration of cultural and spiritual needs.

Palliative care involves communication that is sensitive to cultural and religious backgrounds. This is essential for aged care facilities as well as end-of life care. Physicians should have open dialogue with older adults and seek consent from family members.

Patients and loved ones need to be informed about the available options and possible treatment options. They also need to know the expected outcomes.

It is the only method that allows them to make informed decisions (Keeley (2016)).

Sometimes it can be difficult to communicate effectively with an older adult who has an illness that takes unpredictable turns.

These cases require collaboration between residential aged and primary care providers, diseases specific organizations, and specialist palliative service services in order to discuss and communicate (Petriwskyj und al., 2014.).

Processes of palliative approach to residential aged care

The palliative approach in residential aged care includes ACP or advance care planning.

ACP gives patients’ relatives the ability to make their own decisions and choices, such as how they want them to live until the end.

If a patient with dementia is unable or unwilling to make important decisions regarding their lives, ACP may be available.

ACP assists doctors in respecting the wishes of their relatives regarding care and health insurance.

ACP starts when the prognosis of the patient is higher than six-months. Patients are also reviewed every six weeks.

It is not a single event, but a continuous process of discussing and communicating wishes. This is done soon after residents have been admitted to the hospital (Street et. al. 2015).

There are many preferences and differences between people regarding the concept of end of life care.

Advance care directives are used to allow people to plan ahead, taking into account cultural considerations.

ACD is a method for making decisions and respecting people’s wishes.

Residential aged care services at national and international scales are using ACD as part of routine care to ensure that information is properly transferred between health care professionals, clinicians, and the aged care facilities.

Future decision-making in this system is influenced by the person’s values and beliefs (Crispin. Bestic. & Leditshke. 2015).

ACD refers to a written formal advance care plan. It is an agreement between the individual and the common legislation.

ACDs guide the development of plans for the treatment and resuscitation of patients (Petriwskyj und al., 2014).According to Tuckett et al.

The key components of palliative and end-of life care are case conferences and use a care pathway. This communication is vital for the success of these processes.

Palliative care case conference are initiated when the prognosis is less that six months. Patients are reviewed monthly.

End-of-life care pathways are initiated when the estimated prognosis of a patient is less that one week. Patients are also reviewed daily.

The care facilitators must be aware of the different prognosis of each resident.

A meeting takes place between the care team, the residents and their families at palliative-care conferences.

The meeting covers the issues and current conditions of the residents, and establishes clear goals for care (Reymond. 2014).

End of life care pathway includes a clinical document that guides the delivery high quality care for terminal illness.

If the patient shows improvement, they are removed from end-oflife care.

The normal care routine can be resumed (Reymond, et al. 2016).

These are the Key Issues

The ethical decision making and legal obligations that must be met when palliative care is offered in residential aged care facilities are the primary challenges.

The major ethical issues concern advance care planning documentation, burdensome treatment and poor quality of living, pain management at end of life, treatment adherence, nutrition, and other issues.

Many family members have difficulties making decisions on behalf of the patient when it comes to resuscitation and death.

The care providers must decide based upon the principles of autonomy and beneficence, justice, non-maleficence, and non-maleficence (McLennan et. al., 2015).

Australia is an example of a country that has a large population. It is often difficult to have autonomy when it comes religion and spiritual beliefs.

Torres Strait Islanders, Aboriginals, and Non Aboriginal Australians may hold different beliefs.

Different communities have their own perceptions of “quality-of-life”.

The substitute decision maker for the patient can accept or deny the intervention in a valid ACD (Stokoe und al., 2015.).

It is usually difficult for care workers to remember the various customs that are used to show respect and to respond to dying and dying.

Language is often a key barrier in some cases.

It is assumed that everyone knows and speaks English.

The palliative process is incomplete without translator and interpreter services.

The lack of these services leads to inability to meet spiritual aspects of palliative treatment and legal issues, which delays discussions until the inevitable.

Lack of knowledge and skilled staff regarding the importance to consider the person’s needs, goals, and values can lead to inadvertent decisions and delay in advance care planning documentation (Connolly.

Australia has several laws covering ACD. Each ACD component is named and described in the legislation (Crispin (2015)).

Changes in preferences and their evolution over time are the main issues. ACD may not reflect these changes.

Sometimes the medical direction, which is uinformed, may not be flexible enough for medical treatment.

There are differences in the best practice guidelines and advance care policy between countries.

Unsanitized documentation and information transfer can trigger lawsuits (Broad and al., 2015).

The UK has several legislations to allow the administration of drugs without prescription.

Resident with dementia and communication problems can cause difficulties for residential aged care in administering palliative healthcare.

Australian aged care funding instrument appraises permanent residents as needing palliative treatment.

As residents age, the proportion of funding increases.

These systems have experienced many changes.

The guidelines for a palliative program have been developed by Australia’s government to address the inequities in residential aged-care centres.

These facilities receive different funding than the multi-purpose care units. This affects the delivery of palliative or end-of–life care in residential care centers.

These facilities fund based only on individual needs. However, multi-purpose units provide funding based primarily on the number of beds needed to deliver care. This provides these services with a consolidated source of revenue.

This is why the residential classification system is so important in providing palliative healthcare.

Palliative care patients who have been referred to residential age care are most likely to die before they are discharged. Because of this, careful placement is essential.

In certain situations, the deducted amount may be used to repay capital grants.

Rural and regional capital grants are not used to provide residential care. These factors include geographic restrictions, inability to access non-grant funding and low income residents as defined under the Aged care Act.

The increasing demand for elderly care services is a major burden (Sunget al. (2014)


Palliative care is holistic, and it’s for patients with life-threatening conditions that don’t have any cure options.

The patient’s needs are addressed and incorporated into the palliative approach.

According to the literature review, the need for palliative healthcare is expected to rise in the near future.

They should follow the WHO recommendations.

Additional assessments should be made for any non-satisfactory requirements or other diagnoses that might indicate the need to provide palliative treatment.

The legal and ethical obligations are unavoidable if residential aged care facilities use a palliative approach that does not respect the religious, spiritual and cultural beliefs of residents.

It is important to have clear preferences. They must be used in practice to avoid loss of decision making ability.

ACD must be approached in a systematic way.

ACDs should be organized and communicate with each other to ensure that patients receive the best care possible.

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This simple method of estimating the likelihood that residential aged care will be used in later lives is based on international comparisons.

Australian and New Zealand Journal of Public Health, 39(4), 374-379.Broad, J. B., Gott, M., Kim, H., Boyd, M., Chen, H., & Connolly, M. J. (2013). Where do people die?

A global comparison of deaths in hospitals and residential aged care in 45 populations using published and publicly available statistics.

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Australasian Journal on Ageing, 33(2). 114-120.Crispin, T., Bestic, J., & Leditshke, A. (2015).

Advance care directives in residential care.

Australian family physician 44(4), 186.Free, L. (2018).

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Acute Medicine?A Practical Manual to the Management Of Medical Emergencies, 5th Ed, 625-631.Keeley, M. P. (2016). End?of?Life Communication.

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Resigning or taking charge?

Community perspectives on obstacles and opportunities in advance-care planning.

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General practitioners view the Palliative Car Care Case Conference (PCCC) in Residential Aged Care (RAC).

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Palliative Health Care: Everyone’s Business.

Centre for Palliative Care Research and Education.Petriwskyj, A., Gibson, A., Parker, D., Banks, S., Andrews, S., & Robinson, A. (2014).

The systematic review and analysis of quantitative literature shows that families can participate in decisions regarding residents with dementia.

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The perspectives of residential aged care staff and their primary physicians on the challenges involved in caring for acutely sick residents of aged care facilities: Australas J Ageing.Street, M., Ottmann, G., Johnstone, M. J., Considine, J., & Livingston, P. M. (2015).

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It is worth it to evaluate palliative unit inpatients for residential age care placement.

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What general practitioners thought about the residential aged palliativecare conference: An Australian perspective.

Part 1.

Progress in Palliative Caring, 22(2), 61-68.Tuckett, A., Parker, D., Clifton, K., Walker, H., Reymond, E., Prior, T., … & Glaetzer, K. (2015).

What general practitioners had to say about the palliative Care Case Conference in Residential Aged Care: An Australian Perspective.

Part 2.

Part 2.Virdun, C., Luckett, T., Davidson, P. M., & Phillips, J. (2015).

A systematic review quantitative studies on dying in hospital settings. This study identifies which elements of endof-life care patients and their families consider the most important.

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