Title: Caring for residents in aged care using established palliative care assessment tools.

Background: Palliative care was provided in Australian aged care homes (ACHs) using assessment tools traditionally applied in specialist palliative care settings (SPCS). Including a patient-rated tool, symptom assessment scale (PCOC-SAS) and clinician rated tools; the palliative care problem severity score (PCPSS), Australia-modified Karnofsky Performance Status (AKPS), Resource Utilisation Groups-Activities of Daily Living (RUG-ADL) and Palliative Care Phase (Phase).

Aim: Describe the characteristics of residents in ACHs (symptom distress/problems, functional dependence, care planning needs) receiving palliative care using assessment tools traditionally applied in SPCS.

Methods: Residents identified as needing palliative care by ACH staff were included. De-identified data was analysed including demographic information and results from five assessment tools. Tools were used to describe symptom distress/problems experienced by residents receiving palliative care. Other clinical and demographic information were used to describe residents, their functional dependence and care planning needs.  

Results: We will present final data from participating ACHs. However, preliminary analysis of data collected from January-December-2022 shows 59 residents with an average age of 89.6 years, 71.2% were female. The majority had a non-malignant diagnosis (98.3%), 40.0% of those had dementia. 8,529 PCOC-SAS and 1,650 PCPSS assessments were completed. Any moderate or severe symptoms/problems were investigated.  PCOC-SAS symptoms with the most frequent moderate or severe distress were appetite problems (4.4%), pain (4.3%), fatigue (3.6%) and breathing problems (2.9%).  Moderate or severe PCPSS problems included pain (5.6%) and ‘other’ symptoms (3.1%). Almost half (47.4%) AKPS scores were ≤40 and most (96.6%) RUG-ADL total scores were ≥11. Phase was recorded 1,641 times, ‘Stable’ Phase accounted for 88.0% and most SPCS consults (90.5%) occurred within ‘Stable’ Phase. 

Conclusions: Assessment tools traditionally applied in SPCS can be used to inform and enhance palliative care in ACHs as they describe resident distress/problems, functional dependence and care planning needs.