Written by Professor Jennifer Tieman, Director, RePaDD.
How do we hold a community conversation that addresses the reality of ageing, caring, dying and grieving? The 2019 data analysis by the Australian Institute of Health and Welfare tells us that most deaths in Australia, as in other developed countries, occur in older people. Around two thirds of deaths are among people aged over 75 with a median age at death of 78 years for males and 84 years for females. We are living longer and dying older with around a third of us dying in residential aged care.
I had the chance to speak to this as part of a panel of Flinders researchers presenting a Brave Lecture on The Aged Care Royal Commission: What now? The intent of the lecture was to explore the post-Commission possibilities and directions for aged care from three very different but critical perspectives. My focus was on acknowledging that death and dying is part of aged care and that this has implications for individuals, families, and aged care as part of a national conversation about this important topic.
The Royal Commission noted that:
- High quality palliative care is essential to ensuring that the older person can live their life as fully and comfortably as possible as they approach death
- Compassionate, respectful, and individualised support for older people approaching the end of their lives is a necessary component of aged care services.
Final Report; Care, Dignity, and Respect p94
This to me highlights that palliative care is important and that aged care is important in ensuring we provide appropriate care. As we age, there are different but inevitable pathways leading to the end of life which reflect individual needs and choices, the place where we receive care, and the people providing our care. The challenge is to create a culture and a health and aged care workforce that is able to support these diverse needs.
RePaDD researchers and project staff have been addressing many issues relating to the ageing and dying and this work has taken on greater meaning and urgency with the findings of the Royal Commission.
As part of the ELDAC project, we are contributing to a national program aiming to enhance palliative care and advance care planning in aged care. The Flinders team has a special responsibility for the technology and innovation stream, which is looking at how to support services in organising care through a digital dashboard and through the creation of other innovative resources including a careworker app and online selfcare resources.
The palliAGED project led by Flinders maintains a living evidence base for the aged care sector around palliative care. This guidance informs a range of resources across the sector and has been supplemented by the translation of evidence through practice tips and palliAGED learning modules.
Families and the broader community have access to information about ageing and aged care, and about the diversity of our community within the recently released community portal in CareSearch. These are new resources that can help older people, families and communities understand how to navigate within the health and aged care systems and build awareness of useful actions and planning.
Targeted research studies are addressing critical knowledge gaps relating to bereavement, multimorbidity, support for family carers and the role of allied health in care provision.
As a Centre, RePaDD is playing a major role in addressing death and dying in aged care. We are achieving this by:
- Building an evidence base through research
- Partnering with aged care in research and projects
- Creating technology solutions to support practice change
- Developing new models and processes with, and for, aged care
- Providing older people, families, and communities with information around ageing, caring, dying, and grieving
- Supporting the aged care workforce with pathways to knowledge and learning
Change and improvement requires evidence and a comprehensive and systematic approach, and we acknowledge the importance of being involved in what is next for aged care.