Allied health professionals’ contribution to care at end of life in aged care settings
Jennifer Tieman
A * , Deidre Morgan B , Kelly Jones A , Sue Gordon B and Amal Chakraborty B C
A Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia.
B College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia.
C University of Sydney, Sydney, NSW, Australia.
Australian Journal of Primary Health 29(4) 341-348 https://doi.org/10.1071/PY22178
Submitted: 22 August 2022 Accepted: 8 January 2023 Published: 6 February 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: The Australian population is aging, and the proportion of older Australians will continue to grow over the coming decades. However, there is a lack of research published on the specific roles and responsibilities of allied health professionals (AHPs) providing palliative care within an aged care context. Understanding the roles and needs of AHPs providing care during the last months of life in the community and aged care facilities could contribute to workforce planning, targeted information and improved care.
Methods: In total, 108 eSurveys were collected between November 2019 to May 2020 from three allied health professions working in government-funded aged care; the majority of these being in residential aged care. Descriptive data are reported on the provision of care in key palliative care domains, care settings and practice activity.
Results: Nearly all respondents reported they had worked with older Australians who had palliative care needs. However, over one-third of respondents reported low levels of confidence in supporting clients or residents with palliative care needs. The majority indicated they would benefit from additional education and training and support in palliative care.
Conclusions: This study investigated the role of the allied health workforce in contributing to the care of older Australians at the end of life. It has also demonstrated that there are gaps in practice activity and work role that must be addressed to ensure this workforce can support older people with palliative care needs in receipt of aged care services.
Keywords: aged care, allied health, Australia, dietitians, end-of-life, home care, occupational therapists, palliative care, physiotherapists, residential aged care.
References
Aged Care Royal Commission (2021) Aged care royal commission final report: executive summary. Royal Commission into Aged Care Quality and Safety.Aged Care Workforce Strategy Taskforce (2018) A matter of care Australia’s aged care workforce strategy. Aged Care Workforce Strategy Taskforce. pp. 1–99.
Allied Health Professions Australia (2020) Submission: Royal Commission into aged care quality and safety, aged care program redesign. (Allied Health Professions Australia: Melbourne) Available at https://agedcare.royalcommission.gov.au/system/files/submission/AWF.660.00081.0001.pdf
Allied Health Professions Australia (2021) Rehabilitative care. Available at https://ahpa.com.au/key-areas/rehabilitation/ [Accessed 27 October 2021]
Australian Bureau of Statistics (ABS) (2018) Disability, ageing and carers, Australia: summary of findings. Available at https://www.abs.gov.au/statistics/health/disability/disability-ageing-and-carers-australia-summary-findings/latest-release. [Accessed 12 August 2022]
Australian Bureau of Statistics (ABS) (2020) Twenty years of population change. Available at https://www.abs.gov.au/articles/twenty-years-population-change. [Accessed 8 August 2022]
Australian Institute of Health and Welfare (AIHW) (2019) GEN fact sheet 2017–18: people using aged care. Available at https://www.gen-agedcaredata.gov.au/www_aihwgen/media/2018-factsheets/People-using-aged-care-factsheet-2017%e2%80%9318.pdf [Accessed 12 August]
Australian Institute of Health and Welfare (AIHW) (2021) Interfaces between aged care and health systems in Australia – where do older Australians die? Available at https://www.aihw.gov.au/reports/aged-care/where-do-older-australians-die/summary [Accessed 31 October 2022]
Australian Institute of Health and Welfare (AIHW) (2022a) GEN aged care data: Department of Health 2020 aged care workforce census. Available at https://www.gen-agedcaredata.gov.au/Resources/Dashboards/Department-of-Health-2020-Aged-Care-Workforce-Cens [Accessed 2 November 2022]
Australian Institute of Health and Welfare (AIHW) (2022b) Deaths in Australia. Available at https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/about. [Accessed 31 October 2022]
Blackler A, Brophy C, O’Reilly M, Chamorro-Koc M (2018) Seating in aged care: physical fit, independence and comfort. SAGE Open Medicine 6, 2050312117744925
| Seating in aged care: physical fit, independence and comfort.Crossref | GoogleScholarGoogle Scholar |
Brett L, Noblet T, Jorgensen M, Georgiou A (2019) The use of physiotherapy in nursing homes internationally: a systematic review. PLoS ONE 14, e0219488
| The use of physiotherapy in nursing homes internationally: a systematic review.Crossref | GoogleScholarGoogle Scholar |
Briggs AM, Valentijn PP, Thiyagarajan JA, Araujo de Carvalho I (2018) Elements of integrated care approaches for older people: a review of reviews. BMJ Open 8, e021194
| Elements of integrated care approaches for older people: a review of reviews.Crossref | GoogleScholarGoogle Scholar |
Chahda L, Mathisen BA, Carey LB (2017) The role of speech-language pathologists in adult palliative care. International Journal of Speech-Language Pathology 19, 58–68.
| The role of speech-language pathologists in adult palliative care.Crossref | GoogleScholarGoogle Scholar |
Couch A, Menz HB, Coker F, White J, Haines T, Williams C (2021) Factors that influence workplace location choices in the different allied health professions: a systematic review. The Australian Journal of Rural Health 29, 823–834.
| Factors that influence workplace location choices in the different allied health professions: a systematic review.Crossref | GoogleScholarGoogle Scholar |
Department of Health (2018) The National palliative care strategy 2018. (Australian Government) Available at https://www.health.gov.au/sites/default/files/the-national-palliative-care-strategy-2018-national-palliative-care-strategy-2018.pdf
Department of Health (2020) Types of aged care. Available at https://www.health.gov.au/health-topics/aged-care/about-aged-care/types-of-aged-care. [Accessed 31 October 2022]
Department of Health (2021) 2020 aged care workforce census report. (Department of Health). Available at https://gen-agedcaredata.gov.au/www_aihwgen/media/Workforce/Aged-Care-Workforce-Census-2020.pdf
Department of Health (2022) Allied health workforce data gap analysis. Available at https://www.health.gov.au/sites/default/files/documents/2022/09/allied-health-workforce-data-gap-analysis-issues-paper_1.pdf
ELDAC Project (2021) ELDAC Care Model. Available at https://www.eldac.com.au/tabid/6512/Default.aspx [Accessed 23 June 2021]
Eva G, Morgan D (2018) Mapping the scope of occupational therapy practice in palliative care: a European Association for Palliative Care cross-sectional survey. Palliative Medicine 32, 960–968.
| Mapping the scope of occupational therapy practice in palliative care: a European Association for Palliative Care cross-sectional survey.Crossref | GoogleScholarGoogle Scholar |
Gravier S, Erny-Albrecht K (2020) Allied health in Australia and its role in palliative care. (CareSearch: Adelaide) Available at https://www.caresearch.com.au/caresearch/Portals/0/Engagement-Project/Allied-health-in-Australia-and-its-role-in-palliative-care.pdf
Håkansson Eklund J, Holmström IK, Kumlin T, Kaminsky E, Skoglund K, Höglander J, Sundler AJ, Condén E, Summer Meranius M (2019) “Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Education and Counseling 102, 3–11.
| “Same same or different?” A review of reviews of person-centered and patient-centered care.Crossref | GoogleScholarGoogle Scholar |
Howatson A, Wall C, Turner-Benny P (2015) The contribution of dietitians to the primary health care workforce. Journal of Primary Health Care 7, 324–332.
| The contribution of dietitians to the primary health care workforce.Crossref | GoogleScholarGoogle Scholar |
Lewis LK, Henwood T, Boylan J, Hunter S, Lange B, Lawless M, Milte R, Petersen J (2021) Re-thinking reablement strategies for older adults in residential aged care: a scoping review. BMC Geriatrics 21, 667
| Re-thinking reablement strategies for older adults in residential aged care: a scoping review.Crossref | GoogleScholarGoogle Scholar |
Matlick D, Palmer E, Rehabilitation Operations Council (2019) Assistive technology for patients with cognitive impairments: occupational therapy. Cinahl Information Systems.
Morgan DD, Rawlings D, Moores CJ, Button L, Tieman JJ (2019a) The changing nature of palliative care: implications for allied health professionals’ educational and training needs. Healthcare 7, 112
| The changing nature of palliative care: implications for allied health professionals’ educational and training needs.Crossref | GoogleScholarGoogle Scholar |
Morgan DD, Tieman JJ, Allingham SF, Ekström MP, Connolly A, Currow DC (2019b) The trajectory of functional decline over the last 4 months of life in a palliative care population: a prospective, consecutive cohort study. Palliative Medicine 33, 693–703.
| The trajectory of functional decline over the last 4 months of life in a palliative care population: a prospective, consecutive cohort study.Crossref | GoogleScholarGoogle Scholar |
Nielsen TL, Petersen KS, Nielsen CV, Strøm J, Ehlers MM, Bjerrum M (2017) What are the short-term and long-term effects of occupation-focused and occupation-based occupational therapy in the home on older adults’ occupational performance? A systematic review. Scandinavian Journal of Occupational Therapy 24, 235–248.
| What are the short-term and long-term effects of occupation-focused and occupation-based occupational therapy in the home on older adults’ occupational performance? A systematic review.Crossref | GoogleScholarGoogle Scholar |
Palliative Care Australia (2018) National palliative care standards. Available at https://palliativecare.org.au/standards [Accessed 31 October 2022]
Royal Commission into Aged Care Quality and Safety (2021a) Final report: care, dignity and respect: summary and recommendation. Commonwealth of Australia, Canberra.
Royal Commission into Aged Care Quality and Safety (2021b) Final report: care, dignity and respect Royal Commission into aged care quality and safety, 1. Royal Commission into Aged Care Quality and Safety. pp. 1–340.
Sterke S, Nascimento da Cunha AP, Oomen H, Voogt L, Goumans M (2021) Physiotherapy in nursing homes. A qualitative study of physiotherapists’ views and experiences. BMC Geriatrics 21, 150
| Physiotherapy in nursing homes. A qualitative study of physiotherapists’ views and experiences.Crossref | GoogleScholarGoogle Scholar |
Tieman J (2016) Ensuring quality in online palliative care resources. Cancers 8, 113
| Ensuring quality in online palliative care resources.Crossref | GoogleScholarGoogle Scholar |
Tieman J (2019) Making sense of care at the end of life: the ELDAC Care Model. Available at https://www.caresearch.com.au/caresearch/TabId/3781/ArtMID/6000/ArticleID/886/Making-sense-of-care-at-the-end-of-life-The-ELDAC-Care-Model.aspx [Accessed 12 August 2022]
World Health Organization (2014) Sixty-seventh World Health Assembly, WHA67.19. (World Health Organization: Geneva) Available at http://apps.who.int/gb/ebwha/pdf_files/EB134/B134_R7-en.pdf [Accessed 12 August 2022]
World Health Organization (WHO) (2021) Health services and palliative care. Practical approaches and resources to support policy, strategy and practice. Available at https://www.who.int/publications/i/item/9789240035164 [Accessed 12 August 2022]
