Problem

Residential aged care facilities are a place where people live and die. In 2018-2019, 182,000 Australians lived in residential aged care facilities, and almost 60,000 people died there with an average length of stay of 2.5 years. Eighty-three percent (83%) of exits from permanent residential aged care were due to death. Despite these statistics, there is a known lack of clarity of resident’s end-of-life preferences, and there is evidence that residential aged care facilities do not always provide adequate support for their dying residents. Furthermore, the Royal Commission into Aged Care Quality and Safety revealed that the standard of palliative care provided varies widely. Although residential aged care facilities are high mortality settings, end-of-life discussions are often avoided, by residents, family and friends, and staff as well. This results in end-of-life decision making at crisis points. It is clear that palliative care in residential aged care needs to be improved, so that end-of-life preferences are documented and executed in accordance to the resident’s wishes.

Study Design

The IMPART program aims to improve palliative care in residential aged care using telehealth. The aim is to evaluate the effectiveness of the IMPART program using a mixed-methods stepped-wedge cluster randomised control trial. The IMPART program consists of:

1. an interactive, needs-based end-of-life education program for senior nurses, clinical care coordinators and general practitioners working in residential aged care facilities, and
2. timely end-of-life support from specialist telehealth in-reach.

Ten Victorian residential aged care facilities with a capacity of at least 50 beds per facility will be recruited. Training and palliative-geriatric support to aged care staff and general practitioners to enable timely end-of-life discussions, improve documentation of care preferences, and therefore enable preference-based care, reduce unplanned hospitalisation and improve residents' quality of care at the end of life.

Collaborators

NARI, Austin Health, Melbourne Health, Northern Health, Federation University, Griffith University, Monash University, The University of Melbourne, Newcastle University, University of Queensland.

Funders

The IMPART study is funded by an NHMRC Project Grant (APP2006121) under the Targeted Call for Research into End-of-life Care.

Contact

If you would like to know more about IMPART, please email [email protected] 

Project Summary