Identifying palliative care needs in residential care
Thilini Liyanage A , Geoffrey Mitchell A and Hugh Senior A B C
+ Author Affiliations
- Author Affiliations
A School of Medicine, The University of Queensland, 288 Herston Road, Herston, Brisbane, Qld 4006, Australia.
B College of Health, Oteha Rohe, Albany Highway, Massey University, Auckland 0632, New Zealand.
C Corresponding author. Email: h.senior@massey.ac.nz
Australian Journal of Primary Health 24(6) 524-529 https://doi.org/10.1071/PY17168
Submitted: 29 November 2017 Accepted: 19 August 2018 Published: 14 November 2018
Abstract
The aim of this study is to determine the accuracy, feasibility and acceptability of the surprise question (SQ) in combination with a clinical prediction tool (Supportive and Palliative Care Indicator Tool (SPICT)) in identifying residents who have palliative care needs in residential aged care facilities (RACFs) in Australia. A prospective cohort study in two RACFs containing both high-level care (including dementia) and low-level care beds. Directors of Nursing screened 187 residents at risk of dying by 12 months using first the SQ, and if positive, then the SPICT. At 12-months follow-up, deaths, hospitalisations, use of palliative care services, end-of-life care and clinical indicators were recorded. The SQ had a sensitivity of 70%, a specificity of 69.6%, a positive predictive value of 40.6% and a negative predictive value of 88.7% for death. All residents identified by the SQ had at least two general indicators of deterioration, while 98.8% had at least one disease-specific indicator on the SPICT. The SPICT marginally increased the ability to identify residents in need of proactive end-of-life planning. A combination of the SQ and the SPICT is effective in predicting palliative care needs in residents of aged care facilities, and may trigger timely care planning.
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