There is a variety of community services in Victoria that can support patients at end of life, and their carers. The variety can be confusing so refer to Social Work for help.
Community health services
Community health services deliver a range of primary health, human services and community-based support. There are 88 services that fall into two organisational types:
- 32 independently managed registered community health centres
- 56 community health services that are part of rural or metropolitan health services, including small rural health services.
Community health services provide universal access to care as well as targeted services for vulnerable population groups. They sit alongside general practice and privately funded services to make up the primary health sector in Victoria. Some are also major providers of a range of health and human services including drug and alcohol, disability, dental, post-acute care, home and community care, mental health services and community rehabilitation.
Patients whose needs are not complex from a palliative care perspective, and are not expected to be complex in the near future, will do well with community health services.
Patients with complex needs should be referred to a community palliative care service.
Community palliative care services
Community palliative care services provide specialist end of life and palliative care to people at home or in their aged or disability facility.
There are 36 community palliative care services funded to provide community palliative care. Twenty-seven are in regional and rural areas and nine are in metropolitan regions.
Locating and accessing palliative care services
Community palliative care services share care with other services
In rural and regional areas, district nurses generally provide all nursing care.
In metropolitan areas, however, specialist palliative care services focus on complex end of life and palliative care. They often work in partnership with other nursing services, such as Royal District Nursing Service (RDNS), to manage routine nursing tasks. These tasks include regular insulin injections, indwelling urinary catheters, incontinence and wound care.
You will most likely need to make separate referrals to RDNS and the community palliative care service. RDNS require the Service Coordination Tool Template (SCTT).
If in doubt, confer with the referral coordinator at the palliative care service.
Statewide palliative care services
There are statewide services to support children with a life-threatening illness and people with motor neurone disease (see More about this topic).
Care of older people
Older people live in a variety of settings, including:
- at home independently
- at home with programs and packages to support independent living (requires formal assessment by the Aged Care Assessment Service)
- in Supported Residential Services (privately operated)
- in residential aged care (continuous supported care ranging from help with daily tasks and personal care to 24-hour nursing care),
Aged Care Assessment Services (ACAS) are multidisciplinary, independent teams that facilitate access to commonwealth-funded residential aged care, transition care and home care packages.
Home care packages provide support for ongoing symptoms of ageing but they are not designed to provide palliative care related to life-limiting illness.
The specialist palliative care team will work with the older person’s service providers to ensure care is tailored to their needs.
The palliative care team can support the older person at home in conjunction with the person’s home care package or private care arrangements.
The local specialist palliative care service can support residential aged care facilities with end of life and palliative care. This may involve them visiting for more complex issues or giving advice to staff over the phone.
End of Life Directions for Aged Care (ELDAC) - 1800 870 155 provides information, guidance and resources to support palliative care and advance care planning for older people.
National Disability Insurance Scheme
- The National Disability Insurance Scheme (NDIS) is undergoing a phased rollout across the state.
- The NDIS funds services to address needs related to disability, not life threatening illness.
- Palliative care and NDIS services can work together.
- NDIS supports living in the community and participation in employment and recreation through funding of equipment, home modifications and attendant care.
Refer to Therapeutic Guidelines Palliative Care 2016 Version 4
on the Clinicians Health Channel at your health service.