A key theme of ANZSPM 2016 is providing palliative care for the older person. There is perhaps no greater change to the palliative care landscape than that of our ageing population, and the challenges that this will pose how we approach and define palliative care. This short series of posts will explore some of the key issues in this area of practice.
A particular area of uncertainty currently is how to best provide palliative care for older people; what models of care are best able to the needs of our community? How palliative care is provided in aged care often relies on a palliative approach to care as exemplified by major Australian projects to enhance the care provided by Aged Care Facilities and primary care providers such as The Palliative Approach Toolkit and Decision Assist. Approaches to the interface or integration of specialist palliative care services into such care vary considerably, and there is currently limited evidence to support a system wide approach. Recent studies highlighting the efficacy and feasibility of approaches to integrating specialist care into an aged care setting show some early evidence of possible ways forward.
The EAPC declaration on Palliative Care for Older People highlights that improving care requires first of all recognising the significant needs of this population, needs that area currently often unaddressed. This challenged will be taken up At ANZSPM 2016 with a workshop providing resources on palliative care for older adults will be conducted by Drs Moffat, Hawkins, and Professor McGregor. Other focuses of this workshop will include an update on the palliative approach to frailty and dementia, which will be topics of subsequent blog posts this week.
Palliverse has also been informed that ANZSPM 2016 will see the first meeting of the ANZSPM Palliative Care for the Older Person Special Interest Group on Friday the 9th of September (final details TBC). For any enquiries about this important meeting please contact Felicity Hawkins (felicity.hawkins@research.uwa.edu.au).
Check back for more on palliative care for the older person later in the week.
Michael
palliverse.com 
Specialist palliative services will never be able to cope with the demand. The only answer is for palliative care to become a core skill for generalists; specialist will still have an important role in managing difficult cases, education + research.
On a broader lever, we need a cultural change; helping will elderly relatives and coping with their illness and death should be a school subject
LikeLike
I’m looking forward to the rest of this series, Michael. Those new articles you’ve linked to look very promising (and well-written, I must add)! I can’t wait for the first meeting of the ANZSPMPCOPSIG, sounds like my tribe!
LikeLiked by 1 person
Thanks for your comments Elissa.
It would be great if you were available to come to the SIG. Please also feel free to mention it to any ANZSPM members who you think might be interested. Felicity and I are hoping for a good turnout so we can all contribute to deciding what sort of focus the SIG should have. I look forward to talking to you more about it.
LikeLike
I, too, am excited about the general increase in thoughts on how to care for older people. In my nearly 30 years of medical practice, I’ve found that older people are intensely interested in how they are cared for. Generally, while they are able and cognitively intact, they want to keep going. But no-one wants to linger if they become seriously unwell. They also want to be listened to and their choices respected. More and more of my patients are talking about advanced care planning. More and more are talking about what medications they should be on., and what can be withdrawn. So, the meme, if you like, is getting out there.
Thank you, Michael, for raising this important topic.
LikeLiked by 2 people
Hi David,
Thanks for your comments. I completely agree that the community is becoming more aware of their own voice in the discussions about their care. Increasingly the challenge will be how health care systems respond to knowing what our ageing population expects of their care.
I agree that Advance Care Planning is an important part of the expression of quality person focused care, in articulating individual preferences to the system. However the push for ACP is often focused on an assumption of improving quality through a decrease in inappropriate and unwanted interventions. They have less power in expressing older people’s wishes around the appropriate care they do want to receive, such as person focused care in an aged care setting. In other words while we have gotten better at empowering older people to tell us what they don’t want they are still relatively unheard in determining what they do want from their health care.
David, are you coming to ANZSPM16? Any interest in also attending the SIG?
Thanks again for your comments
LikeLiked by 1 person
Thank you Michael for raising these issues. This week I have had some important discussions with other thought leaders about this topic, particularly about how to fund palliative care in aged care. There is potential for change with the upcoming review of the aged care funding instrument and it has been interesting to throw around different ideas, and consider other models of funding. I think the point you raise about advance care planning is also an important one. Advance care planning is supposed to support individuals to ensure their wishes are heard and are met where possible. There has been significant investments that governments have made in advance care planning across the country. An interesting question might be to evaluate their effectiveness in delivering on consumers wishes. Good luck with the inaugural meeting of the SIG.
LikeLiked by 1 person