What is palliative care in an aged care context?
Palliative care helps an older person with a life-limiting illness live as comfortably and fully as possible. It can begin before the final stage of life, can be provided at home or in residential care, and should support both the person and their family.
Key points
- Make sure the service can safely meet the person's current and likely future needs.
- Individual eligibility, availability and outcomes can vary.
- Ask questions early and seek independent help if anything feels unclear or unsafe.
Palliative care is care for a person living with a serious, progressive or life-limiting illness.
Its purpose is to help the person live as comfortably and meaningfully as possible by managing symptoms, reducing distress and supporting their physical, emotional, social, cultural and spiritual needs.
Palliative care also supports family members and unpaid carers. It can be provided:
in the person’s home
in a residential aged care home
in hospital
through a specialist palliative care service
in a hospice or palliative care unit.
It is not limited to cancer and may be appropriate for people living with conditions such as advanced dementia, heart failure, lung disease, kidney disease, motor neurone disease, Parkinson’s disease or severe frailty.
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01Guide sectionIs palliative care only for the final days of life?
No.
Palliative care can begin when a person is diagnosed with a serious life-limiting illness and may continue for months or longer. It can be provided alongside treatments intended to slow the illness, manage complications or prolong life.
End-of-life care generally refers more specifically to care provided as a person approaches death.
A person may therefore receive palliative care well before they are considered to be in the final stage of life.
02Guide sectionWhat support can palliative care include?
Depending on the person’s needs, palliative care may include:
pain and symptom management
nursing and medication support
help with breathlessness, nausea, fatigue or anxiety
personal care
continence support
assistance with meals and hydration
mobility and pressure-care support
equipment such as hospital beds or pressure-relieving mattresses
counselling and emotional support
spiritual, cultural or pastoral support
support for family members and carers
advance care planning
planning for care in the final days and after death.
The focus should be on what matters to the person, including where they want to receive care, who they want involved and which treatments they would or would not want.
03Guide sectionWho provides palliative care?
Palliative care may involve a combination of:
the person’s GP
nurses
specialist palliative care doctors and nurses
aged care workers
pharmacists
allied health professionals
social workers
counsellors
spiritual or cultural support workers
family and unpaid carers.
Not everyone needs a specialist palliative care team. A GP, community nurse, Support at Home provider or residential aged care team may manage straightforward needs, with specialist advice added when symptoms or decisions become more complex.
04Guide sectionHow does palliative care work under Support at Home?
A person receiving Support at Home may use approved services to support palliative needs, including:
nursing
personal care
help around the home
meal preparation
allied health
transport
counselling and social support.
These services must align with the person’s assessed needs and support plan. Support at Home should work alongside state and territory health and specialist palliative care services rather than replace them.
Clinical services such as approved nursing are fully government funded within the person’s available Support at Home budget, meaning no participant contribution applies. Funding is still limited, so “no contribution” does not mean unlimited nursing or round-the-clock care.
05Guide sectionWhat is the Support at Home End-of-Life Pathway?
The End-of-Life Pathway provides additional short-term home support for an eligible older person who wants to remain at home and is expected to have three months or less to live.
Eligibility requires certification from a doctor or nurse practitioner and includes an assessment of the person’s functional condition.
The pathway currently provides:
$25,000 over 12 weeks
flexibility to use remaining funds for up to 16 weeks
immediate funding once the pathway is approved.
It may fund additional nursing, personal care, household assistance, meals, transport and other approved services. It is intended to complement existing state and territory palliative care services.
A person does not need to already receive ongoing Support at Home services to be assessed for this pathway.
The End-of-Life Pathway is not the same as all palliative care. A person may benefit from palliative care before meeting the pathway’s three-month life-expectancy criteria.
06Guide sectionWhat does palliative care look like in residential aged care?
An aged care home should be able to provide general palliative and end-of-life care as a resident’s health declines.
This may involve:
recognising that the person is approaching the end of life
reviewing medicines and treatments
managing pain and other symptoms
increasing nursing and personal care
providing suitable equipment
reducing unnecessary transfers to hospital
supporting family members to visit and participate
respecting cultural, spiritual and religious preferences
coordinating with the GP and specialist palliative care team.
Residential palliative care should be planned rather than left until a crisis occurs. Families should ask how the home manages symptoms after hours and whether staff can obtain prompt medical or specialist palliative care advice.
07Guide sectionWhat is advance care planning?
Advance care planning involves discussing and documenting the person’s values, treatment preferences and wishes for future care.
This may include:
where the person would prefer to receive care
whether they would want hospital transfer
preferences about resuscitation and life-prolonging treatment
who should make decisions if they cannot communicate
cultural, spiritual or family wishes
who should be contacted as health declines.
Starting these discussions early gives the person more opportunity to remain involved and helps family and care teams make decisions consistent with their wishes.
The legal documents and terminology used for advance care planning differ between states and territories.
08Guide sectionWhat should I ask an aged care provider?
Ask:
What palliative and end-of-life care can you provide?
Do your nurses and workers have palliative care training?
Is nursing support available after hours?
How are pain and other symptoms assessed?
Who contacts the GP when the person deteriorates?
Can you work with a community or specialist palliative care service?
How will family members be kept informed?
Can family stay or visit outside ordinary hours?
How are cultural, spiritual and religious wishes supported?
How do you avoid unnecessary hospital transfers?
What equipment can be arranged?
How will the person’s advance care plan be accessed and followed?
What support is available for family and carers after the person dies?
09Guide sectionWhen should palliative care be discussed?
It may be appropriate to raise palliative care when:
symptoms are becoming harder to control
hospital admissions are becoming more frequent
the person’s condition is progressing despite treatment
eating, mobility or personal care abilities are declining
the person says comfort is more important than further treatment
family carers are becoming overwhelmed
there is uncertainty about what to do during the next health crisis.
Asking about palliative care does not mean giving up. It means adding care focused on comfort, quality of life and the person’s priorities.
10Guide sectionWhat should I do next?
Confirm the details with My Aged Care or the relevant provider, write down your questions and ask for important information in writing before making a decision.
11Guide sectionHelpful Local Home Help resources
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