As modern healthcare has been successful in keeping more people alive, with illness, for longer, the nature of hospitalisation is shifting from cure to care, including managing the end of life. There are more older people in our population; people are living longer; and more people are living with chronic disease, dementia and increasing frailty.
Many people experience disease that results in increased disability often with recurrent hospital admissions and progressive decline over time. Our role is to highlight increasing chronic disease, to shift our focus from prolonging life to maximising quality of life and providing appropriate care to patients and their families.
Palliative care is an approach that improves the quality of life of patients and their families with life-threatening illnesses through the prevention of suffering including physical, psychological and spiritual suffering.
A palliative approach to care is relevant and will benefit any older person who has an illness or condition that is likely to affect how long they will live or if they are becoming frail.
This topic gives an overview of palliative care and recommends actions that we and our organisations can take, in addition to health service policy and procedures, to provide quality care to older patients at the end of their life.
All Australian hospitals are being accredited under The Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. Each of the ten standards relate to optimising clinical care and better outcomes for all patients. Evidence is increasingly supporting the link between effective partnerships, improved consumer experience and high quality health care. This topic specifically links to partnering with consumers (standard 2) but also highlights the need to approach the clinical issues older people face in hospital in a holistic and person-centred way in order to identify and respond to multiple modifiable risk factors throughout their stay. Doing this will improve our systems, clinical care and ultimately the outcomes for older people to recognise and respond to clinical deterioration (standard 9), prevent falls and harm from falls (standard 10) and improve medication safety (standard 4) and prevent and manage pressure injuries (standard 8).