Study into a ‘good death’

A new La Trobe University study highlights how ‘care pathways’ can help GPs and aged care staff work together to plan ‘end of life’ care with residents and their families.

The study, which involved 14 aged care homes in two states, found the use of such pathways improved care. For example, unnecessary transfers from aged-care facilities to hospitals and back again were reduced significantly, from 14% down to 2%.

“If the procedures that make this possible were implemented nation-wide, it would mean a lot less stress during the final stages of people’s lives. They are also likely to save money by using resources better,” research fellow, Dr Dell Horey said.

Published recently in the Medical Journal of Australia, the Good Death project was a joint study between a team of researchers from La Trobe University led by Professor Annette Street and Dr Horey and the Northern Valley Division of General Practice, led by Dr Alison Sands.

The project, funded by the federal government’s Department of Health and Ageing under the Encouraging Best Practice in Residential Aged Care program, calls for a national program to support GPs and care staff use end-of-life pathways to enable aged care residents to die well.

Dr Horey said the pathways support collaborative decision-making between families, GPs and aged care staff by identifying issues that need to be considered at this important time.  

Researchers documented and monitored decisions about care and encouraged all care providers to understand “what was wanted and what was happening”.

Dr Horey said her evaluation showed it was feasible to involve GPs and care staff in the use of care pathways and maintain quality of end-of-life care. 

Pathways enable optimal use of medicines and other therapies to manage symptoms as a result of improved communication with patients, assessment and documentation procedures, she claimed.

She added end-of-life care was increasingly used internationally and was appearing across Australian residential aged care facilities to provide guidance on different aspects of terminal care.

“Pathways are particularly important in complex care environments such as residential aged care where there is a mix of nursing and allied health staff, personal care assistants and general practitioners,” she said.

The study involved interviews with 28 GPs and 42 aged care facility staff, including registered nurses, enrolled nurses, as well as personal care and allied health workers.

The Good Death project involved a consortium of partners across Victoria and South Australia, and included three Divisions of General Practice, 14 residential aged care facilities with more than 1,000 residents, pharmacists, specialist services, and La Trobe University research staff.