Residential Aged Care Communiqué Volume 9, Issue 4, Dec 2014
Download PDF: RAC Communiqué December 2014 edition
In this edition
Case #1 – NFR no more
Case #2 – Another family meeting
Commentary #1 – It is easier to read notes than to read minds
Commentary #2 – Symptom management at end-of-life
The future of the RAC Communiqué
Fiona’s Good Bye
Welcome to the final issue of the RAC Communiqué for 2014. It is a bumper issue with a supplement to cover the complex topics, goals-of-care and end-of-life in Residential Aged Care Services. With the supplement we present four cases, four commentaries and a detailed list of resources.
The cases highlight different aspects of care at the end-of-life and some of the challenges around discussing these matters. Our expert commentaries cover a range of experiences. Three of the commentaries are written by medical practitioners, two are specialists in palliative care, one is a general practitioner and the final commentary is from Professor Rhonda Nay who as we all know is one of Australia’s leading academics in aged care and formidable advocate for better care of older people.
It is curious that not so long ago, everyone was marvelling at the advances in medical science leading to a universal requirement or expectation to provide cardiopulmonary resuscitation. This was the 1970’s, a time when Intensive Care and Coronary Care Units were becoming widely established. Twenty years later, in the 1990s, we recognised that sometimes care could be futile and that setting limits around life-sustaining therapy was a reasonable concept. Another twenty years on, in the 2010’s we see models of shared decision-making with patients and residents, the introduction of advance care planning and National Standards for acute care hospitals to ensure goals-of-care are completed.
Any discussion about goals-of-care and end-of-life generates controversy and debate. Although this is a bumper issue, we still cannot cover all aspects of the topic. However, this should not distract us from ensuring we better understand the purpose and processes involved in providing care for our residents evident from these cases and commentaries.