Essential Component 8
There is quality care during the last days of life

Quality care in the last days of life is safe, effective, responsive and appropriate

Why is this an Essential Component?

Evidence for inclusion

Health professionals should be skilled in recognising the imminently dying patient and responding safely and appropriately to the needs of that person, their families and carers. They should also have the skills to explain clearly and sensitively that a person may be imminently dying to that person, their family and carers, in a way that is appropriate to their circumstances.

Being unaware that a loved one may be imminently dying can compound the distress and subsequent grief felt by families and carers, after what they may perceive to have been the sudden death of their loved one (LACDP, 2014).

Timely recognition that a person may be imminently dying and clear communication of that possibility enables goals of care to be discussed and a plan of care developed, implemented and reviewed so care is responsive to the changing needs and preferences of the patient, their family and carers.

Intended beneficial outcomes

  • Timely recognition of the imminently dying person occurs.
  • Quality care in the last days of life is safe, effective, responsive and appropriate.
  • Care is provided in the most appropriate environment, in accordance with the needs of patients and in consultation with the person, their family and carers.
  • Patients, families and carers are provided with information and support.
  • Care plans are developed, implemented and reviewed regularly to support people who are imminently dying, their families and carers.
  • Patients and care providers across all settings have access to 24-hour-a-day, 7-day-a-week support.
Quality care in the last days of life is safe, effective, responsive and appropriate

What tools/resources could support the implementation of this component?

The Agency for Clinical Innovation commissioned CareSearch (Palliative and Supportive Services, Flinders University) to identify local, national and international tools or resources that can potentially be used to implement each of the ten (10) Essential Components of Care within the Blueprint.

To be included, tools and resources were required to be in English, be applicable to the Australian context and be supported by evidence (such as published validation studies, clinical guidelines representing expert consensus, or advice from expert clinicians who were consulted).

The set of tools and resources provided is not intended to be exhaustive, nor is any one tool specifically recommended. Click here for more information on the methodology adopted by CareSearch in identifying these tools and resources.

Core Palliative Care Tools

  • FAMCARE / FAMCARE2 [PCOC]
    Description
    A Canadian tool for obtaining family/care giver feedback on services - during and/or after the period of palliative care provision. The FAMCARE Scale was developed to measure family satisfaction with advanced cancer care. The next generation FAMCARE tool (FAMCARE-2) was adapted to reflect inpatient and team-based care using palliative care services
    Registration/Payment
    No requirement for registration or payment
  • Palliative Care Assessment tool [PCAT]
    Description
    The PACA form comprises three rating scales. Symptoms are scored on a four-point scale from zero for 'absent' to three for 'daily life dominated by the symptom', assessing the severity of each symptom from the patient's perspective, using a semi-structured interview. Insight is assessed by an observer on a five-point scale, and plans for future care were asked of the patient and recorded on a four-point scale. Facilitation of the appropriate placement for hospital patients is a fundamental element of this measure.
    Registration/Payment
    Reference use to the authors Ellershaw J, Peat S, Boys L. Assessing the effectiveness of a hospital palliative care team. Palliative Medicine. 1995; 9:145-5
  • Palliative Care Outcomes Scale [POS]
    Description
    The POS measures are a family of tools to measure patient’s physical symptoms, psychological, emotional and spiritual, and information and support needs. They are validated instruments that can be used in clinical care, audit, research and training. The POS measures are specifically developed for use among people severely affected by diseases such as cancer, respiratory, heart, renal or liver failure, and neurological diseases.
    Registration/Payment
    Registration is required. No payment is required
  • Support Team Assessment Schedule [STAS]
    Description
    A clinical audit tool, the Support Team Assessment Schedule (STAS), is used to measure outcomes of palliative care. The STAS was developed in the UK to audit community palliative care services provided by a support team. An expanded support team assessment schedule (E-STAS) has been developed (Edmonds et al) to determine symptom prevalence and outcome for inpatients and outpatients referred to a multi-professional hospital palliative care team.
    Registration/Payment
    Registration required – details on website (as per link)

Core Resources

Additional Tools for Specific Populations

Additional Resources for Specific Populations

Core Palliative Care Resources