‘We couldn't have managed without your team’: A collaborative palliative care response to the COVID‐19 pandemic in residential aged care

Abstract

The global COVID‐19 pandemic has challenged healthcare, aged care and palliative care provision in ways previously unimaginable. In Australia, this has been felt particularly amongst our most vulnerable members of society, those residing in residential aged care. Currently representing the majority (75%) of COVID‐19 deaths and health‐care worker infections, this vulnerable sector has borne the greatest impact. A collaborative response comprising a tertiary hospital palliative care outreach service, residential InReach geriatric service and a community palliative care service effectively delivered comprehensive and timely specialist care to residents infected with COVID‐19. Daily videoconferencing rounds were efficient, minimised infection risk and facilitated family members attending virtually during patient assessments and care planning discussions. This model was both reactive and proactive and importantly scalable should further infective outbreaks occur in Australasian residential aged care facilities.

The impact of the COVID-19 pandemic on the residential aged care sector, responses and recommendations: A systematic scoping review

“…One Australian hospital department of geriatric medicine reported implementation of a geriatric outreach service to RACFs, resulting in signi cant hospital avoidance, with the outreach team including a geriatric medicine consultant, clinical nurse specialist and advanced trainee [98]. An Australian study included an innovative model of palliative care service delivery within RACFs during the COVID-19 pandemic, that involved collaboration between a tertiary teaching hospital palliative care outreach service, residential in-reach geriatric service and a community palliative care service [99].…”

Telehealth-facilitated palliative care enables more people to die at home: An analysis of clinical outcomes and service activity data

“…9,10 Recent research provides examples of telehealth-facilitated palliative care that has been rapidly implemented in response to the COVID-19 pandemic and need to control infection. 5,10 However, ambiguity about the role and effectiveness of telehealth demands a stronger evidence base 11 with many services not undergoing evaluation. 12 A lack of routine application of telehealth, especially within palliative care services, 10,13 means that increased evidence is needed regarding the clinical and cost effectiveness, and acceptance of such services.…”

“…5,10 However, ambiguity about the role and effectiveness of telehealth demands a stronger evidence base 11 with many services not undergoing evaluation. 12 A lack of routine application of telehealth, especially within palliative care services, 10,13 means that increased evidence is needed regarding the clinical and cost effectiveness, and acceptance of such services. 11 Clinician resistance to change and lower rates of acceptance of telehealth 14 creates a need to establish evidence regarding the costs and bene ts of a telehealth service.…”

“…7 Given constrained palliative care resources and geographical di culties may inhibit access to care for some people, better use of models of care using newer technologies is needed 8 but are currently underutilized. 9,10 Recent research provides examples of telehealth-facilitated palliative care that has been rapidly implemented in response to the COVID-19 pandemic and need to control infection. 5,10 However, ambiguity about the role and effectiveness of telehealth demands a stronger evidence base 11 with many services not undergoing evaluation.…”