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Identifying palliative care needs in residential care.

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The surprise question (SQ) combined with the Supportive and Palliative Care Indicator Tool (SPICT) effectively identifies palliative care needs in aged care residents. This combination aids in timely end-of-life care planning for residents in residential aged care facilities.

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Area of Science:

  • Gerontology
  • Palliative Care
  • Health Services Research

Background:

  • Identifying residents with palliative care needs in residential aged care facilities (RACFs) is crucial for timely interventions.
  • Existing tools may have limitations in accurately assessing these needs within the RACF setting.

Purpose of the Study:

  • To evaluate the accuracy, feasibility, and acceptability of the surprise question (SQ) and the Supportive and Palliative Care Indicator Tool (SPICT) for identifying palliative care needs in Australian RACFs.
  • To assess the combined effectiveness of SQ and SPICT in predicting the need for palliative care.

Main Methods:

  • A prospective cohort study was conducted in two Australian RACFs with high-level and low-level care beds.
  • Directors of Nursing screened 187 residents using the SQ, followed by the SPICT if the SQ was positive.
  • Outcomes including deaths, hospitalizations, and palliative care service use were recorded over a 12-month follow-up period.

Main Results:

  • The SQ demonstrated a sensitivity of 70% and specificity of 69.6% for predicting death within 12 months.
  • Residents identified by the SQ consistently showed indicators of deterioration on the SPICT (≥2 general or ≥1 disease-specific).
  • The SPICT slightly enhanced the identification of residents requiring proactive end-of-life planning.

Conclusions:

  • The combination of the SQ and SPICT is an effective strategy for identifying residents with palliative care needs in RACFs.
  • This combined approach can facilitate earlier and more proactive end-of-life care planning for aged care residents.