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Aims and objectives This paper examines the use of structured Palliative Care Case Conferences in long-term care. The issues families bring to the Palliative Care Case Conference, their level of distress prior to the conference, the extent to which these issues are addressed by staff and family satisfaction with this process are described. Background In most developed countries, up to 30% of older people die in long-term care. A palliative approach generally refers to the resident and family as the 'unit of care'. Interventions, which include family in palliative care, are required in this setting. Design Descriptive and thematic results from the intervention arm of a pre-post, sequential mixed method study. Methods Examination of documents of 32 resident/family dyads participating in a Palliative Care Case Conference, and interviews with the residents' family postintervention. Results Main concerns raised by family members prior to a Palliative Care Case Conference were physical and medical needs, pain, end-of-life care planning and nutrition and hydration. Families rated a high level of concern, 7.5 on a 10-point rating scale, prior to the Palliative Care Case Conference. A formalised Palliative Care Case Conference process ensured issues relating to end-of-life care planning, pastoral care, pain and comfort and physical and medical needs were well documented by staff. Issues relating to care processes and the family role in care were less well documented. All families, interviewed postintervention, recommended Palliative Care Case Conferences; and over 90% of families felt their issues were addressed to their satisfaction. Families also reported an increased understanding of the resident's current and future care. Conclusions The Palliative Care Case Conference in long-term care provides an important platform for family to voice concerns. Palliative Care Case Conference documentation indicates that staff are attending to these issues, although more reference to concerns relating to care processes and the family role could be made. Implications for practice Increased communication between staff and family, in the form of a Palliative Care Case Conference, may reduce stress, anxiety and unwanted hospitalisations during the palliative phase. [ABSTRACT FROM AUTHOR]

Objective To examine the views of general practitioners (GPs) on providing a palliative approach in residential aged care and in particular their experiences with the palliative care case conference. Background The national project sought to implement and evaluate a comprehensive evidence-based palliative approach in residential aged care. Methods A purposive sample of 11 GPs across Western Australia (2), South Australia (6) and Queensland (3) participated in face-to face, semi-structured interviews. Qualitative content analysis was used to generate the core categories. Results The evaluation by the GPs of the palliative care case conference in residential aged care is explained through three core themes: people, place, and performance. Understanding what GPs say about the performance or 'doing' a palliative care case conference can purposefully inform practice and policy. What GPs say about the people involved and the place in which they work, namely the residential aged care facility, is provided in Part I of this two part series. Conclusion The views of GPs, on providing a palliative approach in residential aged care facilitates, offer a critical reflection on current practices and systems. [ABSTRACT FROM AUTHOR]

Objectives The objective of this article is to explore the introduction of a rapid response team as outlined in the South Australian Palliative Care Services Plan 2009–2016. The Plan identifies this service as being provided by nurse practitioners. This workforce is not yet fully developed so a partnership model utilizing the extended care paramedic has been explored for the provision of out-of-hours emergency care to palliative patients. Methods A working group was established under the auspices of the Palliative Care Clinical Network to progress the partnership model of care. Key stakeholders from SA Ambulance, the Royal District Nursing Society, Flinders University, and Specialist Palliative Care Services (SPCS) made up the steering committee. Satisfaction telephone surveys were conducted following the trial phase to assess the community acceptance of this model. Results Data were collected from across the metropolitan area of Adelaide. There were 40 paramedic visits during the 118 days of the trial, which equates to 10 days per month. About 78.5% of the patients requiring this service were registered with a SPCS. Satisfaction from patients, caregivers, and the extended care paramedics was high. Conclusions This partnership model has enabled an emergency after-hours service to be provided between the SPCS and the ambulance service. This unlikely alliance has been very well received by patients and family members wishing to remain at home. Early data reveals that 90% of unnecessary and unwanted admissions to hospitals have been avoided in the palliative care population. [ABSTRACT FROM AUTHOR]

Objective To examine the views of general practitioners on providing a palliative approach in residential aged care and in particular their experiences with the palliative care case conference. Background The national project sought to implement and evaluate a comprehensive evidence-based palliative approach in residential aged care. Methods A purposive sample of 11 general practitioners (GPs) across Western Australia (2), South Australia (6), and Queensland (3) participated in face-to-face, semi-structured interviews. Qualitative content analysis was used to generate the core categories. Results The evaluation by the GPs of the palliative care case conference in residential aged care is explained through three core themes: people, place, and performance. Understanding what GPs say about the people involved and the place in which they work, namely the residential aged care facility, can purposefully inform practice and policy. What GPs say about the performance or 'doing' a palliative care case conference is provided in Part II of this two part series. Conclusion The views of GPs, on providing a palliative approach in residential aged care facilitates, offer a critical reflection on current practices and systems. [ABSTRACT FROM AUTHOR]

The Australian Integrated Mental Health and Palliative Care Task (IMhPaCT) project aimed to improve the quality of palliative care for people with a severe and persistent mental illness and those who develop mental health issues as a response to their diagnosis of a life-limiting illness. These patients and families are generally cases of high complexity and require strong collaboration and cooperation across various service sectors. Education across both palliative care and mental health services was identified as a key objective in improving palliative care service delivery in this patient population.This article specifically addresses one aspect of the project-the education strategy. The processes of development, implementation, and evaluation of outcomes are discussed. [ABSTRACT FROM AUTHOR]

Aim To explore discrepancies between nurses' knowledge and their documentation of issues of psychosocial, spiritual and cultural aspects of palliative care, evidenced clearly in recent nursing research into end-of-life care in an acute care, teaching hospital. Design The study involved a retrospective patient case-note audit of an opportunistic sample of 20 patients deceased recently and interviews of the two nurses most involved in the care of each patient (n = 40). Findings This research indicates that nurses in acute care settings often recognize, sometimes explore, but infrequently document psychosocial, spiritual and cultural aspects of care. Conclusion There is a strong need for: (1) education about both the impact of non-physical dimensions of patients' lives and the effective documentation of these dimensions; and (2) up-grading of documentation tools to better facilitate documentation of non-physical aspects of palliative care. [ABSTRACT FROM AUTHOR]

Recognizes the need for palliative care in aged care . Definition of palliative care by the World Health Organization; Increase in the population of residential aged care facilities; Culture background of the residential aged care facilities in Australia; Launch of guidelines for the implementation of a palliative approach in residential aged care; Goal of palliative care assessment; Consideration of the range of palliative approaches; Factors used to discriminate between the ranges of palliative approaches for an individual; Description of ethical palliative care.