Mrs Sabina Clapham1, Mrs Alanna Connolly1, Mrs Laura Bryce1
1University Of Wollongong, Wollongong, Australia
Biography:
Sabina Clapham is the Quality and Education manager for the Australian Palliative Care Outcomes Collaboration (PCOC) and a Registered Nurse with experience in palliative care in various clinical, education, quality and project management positions. In her current position, Sabina ensures the implementation and sustainability of the PCOC program and leads clinical practice changes within PCOC services.
Abstract:
Background: The proportion of the population who could benefit from palliative care is increasing due to disease and age-related trends. Equally, the demand for palliative care is growing, especially for those in residential aged care (RAC). Knowledge about those who are receiving palliative care in this setting is lacking.
Aim: To compare residents referred to specialist palliative care services (SPC) with those identified by RACs.
Methods: Routinely collected data from palliative care services participating in the Palliative Care Outcomes Collaboration (PCOC), and RACs participating in the newly established Palliative Aged Care Outcomes Program (PACOP) between January to December 2023. Demographics, characteristics, functional status, problems, and symptoms were captured using the Palliative Care Phase, Australia-modified Karnofsky Performance Status (AKPS), Palliative Care Problem Severity Score (PCPSS), and Symptom Assessment Scale (SAS).
Results: 7,145 residents received 8,305 SPC consultation episodes, with 44% referred from RAC and 25% from hospitals. Among SPC recipients, 69% had non-malignant diagnoses, including 26% with dementia. RACs identified 480 residents with palliative care needs, 34% of whom had dementia or cognitive impairments. Initial assessments showed 47% of SPC recipients with an AKPS score ≤30. Common moderate to severe issues included family/carer concerns (9.5%), pain (10%), and psychological/spiritual issues (6.7%). Among RAC identified residents, 64% had AKPS scores ≤30, with notable issues being family/carer concerns (12%), pain (17%), and psychological/spiritual issues (12%).
Conclusion: Residents referred to SPC service and those recognised by RAC were more similar than different. Almost half of all referrals to SPC originated from RACs, highlighting the role of RACs as gateways to appropriate palliative care. Additionally, hospitals significantly contributed to SPC referrals, emphasising the necessity for standardised referral criteria to improve accessibility to palliative care in aged care.