400837 Health And Socio Political Issues In Aged Care


Here’s a task you will need to complete:

Discuss the concept of a “palliative” approach to residential aged-care end of life care. Then, discuss and evaluate how this approach might be applied in practice.

Discuss policies related to residential aged care’s advanced care directives and end-finance model.

An overview of the oaliatrve concept and how to promote it at a national or international level in residential aged care.

The unique discussion of the issues surrounding palliative and hospice care in residential aged homes.

The discussion should also cover the funding of aged services and how that impacts palliative care for aged people.

An essay should have an introduction, body and conclusion. Subheadings might help you structure a longer essay.

Use contemporary literature to define the terms ‘panelme’ and ‘end-of-life care’

Talk about advanced care directives from an ethcal perspective

You might consider the possibility that a palliative care approach to end of life care could be ante funded by reSidental Care faCilities

This article will critique these concepts and approaches with reference back to the literature



Palliative services are intended to improve the quality of life for patients suffering from progressive diseases.

Patients who receive palliative treatment have an incurable disease that is not curable.

Palliative Care is care that is given to patients suffering from life-threatening illness. It provides relief and prevention by early diagnosis, assessment, treatment, and recovery of pain, psychological, physical, or spiritual problems.

Palliative services can be delivered in a variety of settings, such as paediatrics, neonatal units and acute hospitals. They also provide residential aged care services.

Specialist services can be provided from community-based services, inpatient or hospice care (Parker and colleagues, 2013).

The paper discusses Palliative Approach in End of Life Care in Residential Aged Care at a National and International Level.

The analytical paper aims to present the concept of palliative and provide evidence for its application in policy or practice.

This paper presents a critique of how palliative care is used in practice for older adults.

This paper discusses policies surrounding advance care directives, and models of funding residential aged care.

It also includes discussion on issues in palliative and its impact.

Palliative care

Palliative derives its name from Latin “palliatus”, which translates to hidden or covered in cloak. It refers “relieving, but not curing” (Zimmermann and al., 2014).

Palliative care is offered to patients suffering from progressive and active diseases that have no prospects of being treated.

This covers the advanced stages of cancer and non-malignant conditions, such as heart disease, dementia motor neurone disease respiratory failure, renal failure or Parkinson’s disease.

This approach affirms the existence of life. It provides pain relief and relief for other distressing symptoms.

According to this approach, death is considered a normal process, and all efforts are made not to hasten or prolong it (Parker, et al. 2013, 2013).

Some countries distinguish between hospice care or palliative treatment.

These two approaches have a similar philosophy.

The US has a distinction. However, the two aspects are different in terms of the payment system and the place where the services are provided.

In the UK, both hospices and non-hospice teams of palliative are able to provide care to patients at any stage of their illness. This care is not curative.

Many health professionals aren’t specialists but still apply palliative principles to their work every day (Free, 2018).

The importance of palliative care in Australia is well-known and all health professionals consider it to be a core competency (Broad et. al., 2013,).

Culture plays a fundamental role in an individual’s life.

Cultural and spirituality play a crucial role in one’s daily life.

In many cases, health beliefs have been shown to be strongly linked to religious or spiritual affiliations as well cultural backgrounds (Mazanec-Panke, 2015).

Palliative Care combines spiritual, psychological, and cultural aspects to allow a patient to live active until the end.

Palliative Care also addresses the family’s wants and needs, such as dealing with bereavement. (Free, 2018).

End of life care

End-of-life care is provided to patients in the last few months or years of their lives.

It covers patients who are likely to die, such as those with advanced stages of cancer, stroke, dementia, and patients who have had to deal with a devastating event in their lives.

The care has two goals: to ensure dignity in death and to allow the dying person to live as full a life as possible.

The wishes, preferences, and views of family members of the patient are taken into consideration when providing care.

Patients with disabilities have the right to high quality care. They are allowed to voice their preference for receiving care at home or in a care home.

The end-of-life care is provided by hospital doctors, nurses, community personnel, general practioners and counsellors.

If the patient has to be cared for at home, the general practitioner is responsible for the overall care.

If the patient is suffering from distressing symptoms or pain, palliative treatment may be provided.

This approach provides comfortability for patients (Virdun et.al., 2015).

Palliative Approach to End Of Life Care in Residential Aged Care

Both at national and international levels, the residential aged care facilities have been designed to allow medical professionals to access patients’ files and allow for the palliative approach.

The palliative approach is best supported by residential aged care facilities. They facilitate open communication between patients, aged care professionals, and their families (Tuckett and colleagues, 2015).

These facilities provide skilled staff that can deliver quality care at any hour of the day.

A staff with the right skills mix will help to reduce the likelihood of patients being transferred into acute care. This will also decrease distress for both the patient and the family.

The aged care staff’s role is to continue professional development and education regarding the palliative method.

Palliative care in an aged care facility includes many elements.

It also incorporates the principles autonomy, dignity, respect, and comfort.

It is about having open and honest communication with older adults regarding their current conditions and possible treatment options.

Palliative care teams must provide options for older adults to choose from the best evidence-based treatment methods.

Palliative care is a holistic approach to the final stages of life. It involves pain relief and effective management for distressing symptoms.

It involves providing people with the kind of access they want and fulfilling their cultural and spiritual needs (Mazanec, Panke 2015).

The palliative team provides care to patients with life-limiting illnesses and helps them live longer.

But, the goal of palliative care is not to delay or hasten death (Free 2018, 2018).

Spiritual considerations are providing support such as pastoral care workers and aromatherapy resources.

Parker et.

Parker et al. (2013) state that the medical practioners direct care for elderly persons with life-limiting diseases in residential aged care facilities.

Practioners have the responsibility of prescribing medication or treatment and making decisions about treatment.

These practioners play an important role in this process.

The goal of palliative and urgent care must be clearly defined by the practitioner.

Medical practitioners must ensure that patients with chronic diseases and elderly people at the end are provided with palliative and appropriate care.

It is vital to care according to the patient’s comfort, not their cure.

The proper care does not mean that the elderly patient should be admitted to hospital.

(2014) suggested that the palliative approach should minimize distressing interventions to patients wherever possible, even if they can be cured in-situ.

Some hospital visits may still be necessary in order to provide comfort.

The emphasis is on relieving distressing symptoms through positive approach and taking into account spiritual and cultural needs.

Palliative care is about communication and planning that takes into account the cultural and spiritual background of the care recipient. The practice must communicate openly with older adults in the aged-care facility and seek consent from family members.

It is crucial that patients and their loved one understand the options available, the treatment options, and the possible outcomes.

It is the only way to help them make informed decisions (Keeley 2016,).

It may be difficult for older adults to communicate with one another when their illness is unpredictable.

Collaboration is required between residential aged services, primary caregivers, disease specific organizations, specialist palliative care service providers and other health care professionals in these cases for communication (Petriwskyj, et al. 2014).

The Residential Aged Care Processes: A Palliative Approach

ACP, or advance care planning in Australia, is part of the Palliative Approach to Residential Aged Care.

ACP allows relatives to make decisions or choices on behalf of patients, including how they want to die.

In cases of dementia, it may be used to help the patient make decisions about their own life.

ACP helps doctors honor the wishes of family members regarding care and insurance.

ACP begins if the expected prognosis for the patient is more than six months. Patients are re-examined every six months.

But, ACP is not just a one-time event for communicating and documenting wishes. It is an ongoing process that is initiated soon after the resident is admitted (Street, 2015).

Although people may agree on the concept of end-of life care, there are many differences.

Advance care directives (ACD) are the process that allows people to plan ahead for decisions.

ACD refers to a method of taking decisions that respect the wishes of the person.

The residential aged care service is using ACD at both the national and international levels. This allows for the appropriate transfer of information among the clinicians, doctors, and the aged care facilities.

This system is based upon the person’s preferences, values, and beliefs.

ACD is the formal advance-care plan in writing, which is approved by both the individual as well as the common legislation.

ACDs provide information about the plans that relate to clinical care treatment and resuscitation. (Petriwskyj and co., 2014).

2014 palliative case conferences and the use an end-of life care pathway will only be successful if there is open communication among all residential care team members.

When the prognosis of palliative patients is less than six month, case conferences are initiated. Patients are reviewed monthly.

When the prognosis is less than one week, end of life care pathways are initiated. Patients are reviewed daily.

Each member’s prognosis should be known to the care facilitators.

The care team meets with the residents and their families to discuss palliative healthcare conferences.

The meeting addresses the residents’ current needs and sets clear care goals (Reymond (2014)).

The clinical document in the end-of-life care pathway guides the delivery and quality of care for patients who are at terminal stage of their illness.

If the patient shows improvement, they are removed from end-of life care.

The usual care routine is resumed. (Reymond et. al., 2016).

Important Issues

The main challenge with palliative approaches to residential aged care facilities lies in the ethical decision-making as well as legal obligations.

The ethical issues most relevant to palliative care are the following: advance care planning, documentation, burdensome treatments, poor quality life, pain management at death, treatment adherence, nutrition and hydration.

Family members often report difficulties in making decisions regarding the death or resuscitation of a patient.

The principles of autonomy, beneficence (non-maleficence), justice and justice must be followed by the care providers (McLennan, et al. 2015).

Australia is a country with a diverse population. It can be difficult to preserve autonomy when it comes to religious and spiritual beliefs.

For example, Aboriginals as well as Torres Strait Islanders may have different beliefs than Non Aboriginal Australians.

Different communities have different views on what constitutes quality of life.

Therefore, the substitute decision-maker of the patient can accept or decline the intervention in an ACD. (Stokoe, et al. 2015).

Most cases, it is difficult for caregivers to remember the different customs that are used to show respect and to respond to dying and dying.

Language is a major barrier in several cases.

It is assumed everyone speaks and understands English.

Translation and interpreter services are essential components of the palliative approach.

Inadequate provision of these services can also lead to inability to address spiritual and legal aspects of palliative care. This delays the process until death is imminent.

The lack of qualified staff and knowledge about the importance of considering the person’s goals and values delays informed decisions and advance planning documentation (Connolly, et al. 2014).

Australia has many laws that cover ACD. They include the name and nature of the legislated instruments.

But, it is important to consider changes in people’s preferences over the years, which may not have been updated in ACD.

Sometimes the medical directives, which may be uinformed are not specific enough to change during treatment, or too general to guide decision-making.

The best practice principles and advance care policy are different in different countries.

The transfer of information and inappropriate documentation can trigger lawsuits (Broad et. al., 2015).

There are several laws in the UK that allow for the administration and management of medicines without the need for prescription.

Because residents with dementia and communication difficulties make it difficult to administer palliative services in residential aged care.

Permanent residents are assessed as needing palliative services under the Australian aged care funding instruments.

The percentage of funding increases as the resident’s age.

These systems have seen many reforms.

The Australian government has established guidelines for a palliative strategy to address the inequities in residential aged-care centres.

The funding for palliative care and end-of life services in residential care facilities is affected by the difference between these centres and multi-purpose service units.

The funding for these facilities is based on individual requirements, while the funding for multi-purpose units is based upon the agreed amount of beds needed to provide care. This translates into a consolidated revenue.

In order to provide palliative services, it is important that the residential classification scale be used.

The majority of palliative inpatients admitted to residential aged care die before they are discharged. This is why it is crucial to ensure that the placement is correct.

In some cases, the capital grant repayments may require that the sum be deducted.

Residential care is not available in rural or regional areas despite capital grants. This could be due to geographical location, lack of funding for capital work or low-income residents as defined under the Aged care Act.

The growing demand for aged care services is a burden (Sung, et al. 2014).


Palliative care provides holistic care to patients who have a life-threatening illness that has no hope of recovery.

While addressing patient’s issues, it also addresses their psychological, spiritual, and cultural concerns.

Based on the literature review, it is clear that palliative services will be more needed in the near future.

It is important that the services be in line with WHO recommendations.

Further assessments are necessary for unmet requirements or other diagnoses requiring palliative treatment.

It is a violation of ethical and legal obligations to ensure that residential aged care facilities’ palliative approaches do not reflect the cultural, spiritual, and religious beliefs and values of residents.

To prevent the loss of decision-making ability, there is a need for clear preferences. This must be practiced.

ACD requires a systematic approach.

ACD should be managed with planning and communication in order to meet patients’ needs and preferences.


Probability of residential aged care usage in later years: A simple method to estimate using an international comparison.

Australian and New Zealand journal for public health, 39(4). 374-379.

A global comparison of the deaths that occur in hospitals and aged care facilities in 45 countries, using both published and unpublished statistics.

International Journal of Public Health 58(2): 257-267.

Residential aged care is the de facto hospice for New Zealanders over 60.

Australasian journal about ageing, 33(2) 114-120

Advance care directives in residential elderly care.

Australian family doctor, 44(4),186.

Palliative and End-of-Life Care

Acute Medicine:A Practical Guide for the Management of Medical Emergencies 5th Edition, 625-631.

The International Encyclopedia of Interpersonal Communication.

Literature review: The support roles of religions and spirituality in the end-of life and palliative care for patients with cancer in a culturally diverse setting:

Current opinion in supportive or palliative care, 9(1). 87-95.

Cultural considerations in palliative medicine.

Spiritual, religious, and cultural aspects of care, 4.

Resigning or taking control?

Community perspectives about barriers and opportunities for advance care planning.

Australian Health Review 39(5), 528-532.

Views of general practitioners at the Palliative Care Conference (PCCC), residential aged care (RAC).

In APCC2013 – 12th Australian Palliative Care Conference.

Palliative Care is for everyone.

Centre for Palliative Care Research and Education.


International journal for evidence-based healthcare 12(2), 64-86.

The care model.

End of Life Care: Proactive Clinician Management of Older Australians.

The Royal Australian College of General Practitioners 45(1-2).

An retrospective cohort study, based on population data, of access to specialist palliative treatment in the last year. What is missing a decade later?

A discussion between staff at residential aged care facilities as well as their primary care physicians about the difficulties associated with caring for elderly residents in acutely sick aged care facilities.

Advanced care planning for older Australians presenting to the emergency room from their community or residential aged care facility.

23(5): 513-522.

Evaluation of residential aged care placement inpatients from palliative medicine units: Is it worthwhile?

Journal of palliative Medicine, 17(2), 209-208.

The Australian perspective on what general practitioners had to say about the residential aged care palliative-care case conference:

Part 1.

Progress in Palliative care, 22(2): 61-68.

The Australian perspective on what general practitioners thought about the residential aged care palliative-care case conference:

Part 2.

Progress in Palliative Caring, 23(1), 9-17

The hospital environment for dying: A systematic review of quantitative research identifies the key elements of end of life care that patients and their family consider most important.

Palliative medicine. 29(9). 774-796.

A cluster-randomised controlled study of early palliative treatment for advanced cancer patients.

The Lancet 383(9930), 1721-1730.