The number of Australians over the age of 65 is rising, and during the next three decades, the proportion of the population aged over 85 will more than double. This demographic change is driving significant growth in demand for aged care. The availability of home care packages has significantly expanded in the last decade to allow people to be cared for in their homes including those that require palliative care. A shift in the complexity of people moving into residential aged care has also occurred; people are older, frailer and have more complex care needs. Across the spectrum of aged care services there is a need and expectation for people to have their end-of-life needs met.
The government-funded initiative End of Life Directions for Aged Care (ELDAC) aims to connect people working in aged care to palliative care and advance care planning information, resources and services. ELDAC initiatives include a navigation and phone advisory service, technology solutions, partnership projects and policy initiative. A major resource is the development of five online toolkits which provide support to aged care staff, specialist palliative care professionals and general practitioners (GPs) to provide a comprehensive evidence-based, person-centred and sustainable approach to palliative care and advance care planning. These toolkits build on previous work of the consortium partners.
Toolkits can be broadly defined as a collection of information, resources and tools around a particular topic or practice area. They have increased in popularity across health care settings. Hard copy or online, they can help users to develop a plan and organise their efforts to follow evidence-based recommendations or practices.
The ELDAC toolkits are interactive and have been built and reviewed by experts working in aged care, specialist palliative care and primary care. While the format of each ELDAC toolkits varies, they are online and presented in a user-friendly format for ease of use by direct care staff including nurses, care workers, allied health professionals and GPs as well as staff in managerial, quality or educational roles. All five toolkits provide up-to-date clinical evidence, learning opportunities and organisation tools to support palliative care and advance care planning.
The Residential Aged Care Toolkit and Home Care Toolkit are built around the ELDAC framework: eight key domains mapped to elements essential to providing quality palliative care and advance care planning for older Australians. Evidence-based clinical guidance is available in the ‘What I can I do’ section, while staff can identify their learning needs and set a learning plan in the ‘What I can learn’ section. The ‘What my organisation can do’ section provides direction in setting up a palliative care and advance care planning working group and includes organisational and clinical audits linked to a quality improvement framework.
The Primary Care Toolkit, tailored for primary care staff including GPs has a similar structure with clinical information, links to education and mapping of health pathways across Australia. The Legal Toolkit provides factsheets and practical help for seven commonly encountered legal issues in palliative care and advance care planning. The Working Together Toolkit provides evidence-based strategies for connecting the aged care, specialist palliative care and primary care sectors.
As online products, the five toolkits can adapt to changes that occur across the aged care, palliative care and primary care sectors. New additions to toolkits taking into account sector changes and user feedback will be incorporated during the project which will run through to 2020.
You can visit the ELDAC website and use ELDAC toolkits via the following link: www.eldac.com.au.
Deborah Parker, Professor of Nursing Aged Care (Dementia), Faculty of Health, University of Technology Sydney