Analytical Essay: Health and Socio-Political Issues in Aged Care

This analytical essay explores the provision of palliative care in residential aged care, focusing on health and socio-political issues. It highlights the importance of palliative care in improving the quality of life for patients and their families facing life-threatening illnesses. The essay discusses the approach and application of residential aged care palliative care in Australia, emphasizing the principles and considerations necessary for delivering high-quality services. It delves into the perception and evaluation of psychological and physical health needs, family-centered care, and the importance of decision-making and planning involving consumers, caregivers, and families. Furthermore, the essay addresses equitable access to end-of-life care, pain management systems, and the role of trained staff in delivering palliative care. It also covers advanced care planning and directives, including codes of ethics and the best application of these plans in residential aged care facilities, stressing the need for readily available strategies, training, and documentation.

Running head: HEALTHCARE ANALYTICAL ESSAY 1
HEALTH AND SOCIO-POLITICAL ISSUES IN AGED CARE
Student Name
Institution Affiliation
Facilitator
Course
Date

HEALTHCARE ANALYTICAL ESSAY 2
PALLIATIVE CARE PROVISION IN RESIDENTAL AGED CARE
Introduction
In accordance with the World Health Organization (WHO), “palliative care is an
approach made to improve the quality of life of the patients and their families facing the
problems associated with life-threatening illness, through the prevention and relief of suffering
by means of early identification and impeccable assessment and treatment of their pain and other
problems such as physical, psychological and spiritual ones.” Many different terminologies are
used to describe the term across different sectors such as; “hospice” or “end-of-life” care
(Brinkman-Stoppelenburg, 2014).
This kind of care is based on some general principles which underpin its role. It ensures
the provision of aid on torment and other troublesome conditions. It affirms living and sets death
as an ordinary process which everyone has to take. It intends neither to rush nor defer the demise
of the patients under care program. It ensures the integration of the psychological and profound
patient’s healthcare parts. It offers an emotional support system to enable the residents to live
happily until their demise. It offers emotional support to allow the families of the resident to
cope with their conditions and bereavement.
Approach and application of residential aged care palliative care
The aged no longer stay at their homes, they are taken to residential programs which cater
to their needs better and purposely their health in a better way in Australia. To ensure this
program runs efficiently, the Australian government sponsors private aged consideration
administrations for older Australians whose care needs are advance and they never again stay in
their very own homes but residential. The residential programs provide services to individuals in
need of continued healthcare and nursing because of the limitations of their abilities to take daily

HEALTHCARE ANALYTICAL ESSAY 3
activities (Stewart-Archer, 2012). They get nursing, supervision or different kinds of individual
consideration required by the residents in this care program.
Aged care is described better under the “Aged Care Act 1997”, within the Quality of Care
Principles (Koren, 2010). There are specific principles which should be upheld for the approach
to be efficient and thorough. The residential aged care according to its principles ensures that
palliative care is delivered to the best and ensures that the aged live their best dignified and
comfortable life in their remaining days. This is probably because they are at a higher risk of
death than any other age bracket and under any other form of palliative care program. This
program also supports the families and the guardians during their mourning or in taking care of
their loved ones and also supports the professionals to ensure they deliver the best care to this
group.
The approach of palliative care in residential care
In order to ensure that the residential aged care gives its best quality services, some
approaches are applied to supplement everything. Some things are put into consideration to
ensure that the aged, their families and guardians, and anyone involved is protected against
impromptu situations.
The perception and evaluation of psychological and physical health and needs at the last
days of their lives (Richards et al, 2011). The palliative care ought to be perceived as a
component of the ordinary extent of routine with regards to the residential aged care, recognizing
that these facilities are home for some individuals toward the last days of their life. The care is
always focused on the family and the consumer’s condition. The needs of the residents and
services administrations are surveyed, recorded and routinely audited from time to time. The
phases of life-constraining conditions are perceived and the necessary palliative care is

HEALTHCARE ANALYTICAL ESSAY 4
approached necessarily according to palliative care needs. There is an assurance that in cases that
the wellbeing status of the consumer changes it is urgently reported to ensure that it is met. The
psychological well-being needs of patients are evaluated, reported and met including treatment
for nervousness or sadness whenever required in these facilities.
Decision making and planning involves the consumers, caregivers and the families
concerned in palliative care (Chan, Webster, & Bowers, 2016). These facilities ensure they
provide adequate education regarding the phases of the life-restricting condition and treatment
alternatives and bolstered through treatment choices if conditions change to the families,
caregivers, and consumers. Support is also given to the consumers, caregivers and the families to
create and routinely audit advance consideration plans, especially if conditions change.
Discussion is held between the consumers and the providers frequently to understand the
ramifications of treatment decisions and distinctive palliative care decisions, with their
necessities and wishes recorded (Bigby, Bowers, & Webber, 2011). They are bolstered to change
advance consideration plans or treatment choices if conditions change this is because they
comprehend their entitlement to ask for life-longevity care services. They also understand that
except if legally necessary, specialists are not obliged to start or proceed with medicines that
won't offer a sensible expectation or advantage or improve the patient's personal satisfaction. If
need be, another decision maker can be identified and involved in the discussion of the patient's
expectations and requirements.
Insurance that all the consumers get equitable and timely access to suitable facilities of
end-of-life care (Ramsey et al, 2017): Suitable palliative consideration support to consumers,
paying little attention to their financial status, geographic area, background, prognosis or
diagnosis.

HEALTHCARE ANALYTICAL ESSAY 5
Insurance of sufficient and opportune agony and indication management system for the
consumers: Appropriate fitting gear and instrumentation to help palliative care and oversee signs
and symptoms of the aged should be adopted.
Well trained staff and skilled staff are considered when integrating and coordinating
healthcare delivery in the residential aged care facilities (Dwyer, 2011). High competency is
really considered when recruiting laborers for the provision of this type of health care. This type
of care is considered to be administered by fittingly prepared and talented staff and groups. They
are well trained and prepared and bolstered to perceive when palliative care is required and when
the consumer needs to have changed from a certain treatment to another. The services are
adequately resourced to convey palliative care which incorporates the use of specialized
materials and equipment. The staff should effectively create and archive care plans and a
minding pioneer is recognized to guarantee care as needed, as per the consumer and family
wishes facilitation. Approach to an expert of palliative care when required is among the services
offered and hence professionals should be available all the needed time. The responsibilities of
every one of those engaged with palliative care are perceived, regarded and supported. Staff
administrations are properly supported in taking care of the patients with life-constraining
conditions. Exchanges to different services happen to depend on consumer or caregiver decision,
with consideration plans shared.
Consideration of the persons living with different health conditions like dementia and
ensuring that they get the care appropriately (McKeown et al, 2010). Dementia is perceived as a
terminal sickness. Possibly, staff should empower and support palliative care decision making
and planning with the early association of the aged, family, and caregiver after diagnosis has
been made. Services should furnish proper consideration to customers with social and mental

HEALTHCARE ANALYTICAL ESSAY 6
symptoms of dementia, guaranteeing every single suitable administration including end-of-life
care are recognized, accessed and documented.
Treatment of the consumers, caregivers, and families with respect and dignity: Patients as
well as the families and the caregivers are treated with poise and respect all through end-of-life
care and even after death. They are also upheld to invest as much energy and time with a friend
or family member as they wish even after death. Close care needs should be taken care of
normally and regarding the patient and their family and caregivers. Patients’ assets should be
taken care of and taken back to the family in an auspicious way after death.
Advanced care planning and directives
Advanced care planning: This is a procedure of making arrangements for the future
wellbeing and individual care whereby an individual's qualities, convictions, and inclinations are
recognized so they can help in making decisions at a future time when the consumer is unfit to
convey their decisions (Meron, 2014). This talk should regularly result in a development care
plan setting. These plans state inclinations about wellbeing and individual care and favored
wellbeing results. Choices might be made for the individual's sake, however, an individual's
desires ought to be followed to manage decision making.
Advanced Care Directives: these are one method for formally recording a development
care plan. It is a kind of written care plan perceived by customary law or approved by the
enactment that is signed and completed by a skilled person. It is composed of the individual's
inclinations for future consideration and names a substitute person to make decisions on behalf
of them. The substitute is an individual recognized by law as ready to settle on substitute choices

HEALTHCARE ANALYTICAL ESSAY 7
in the interest of somebody who does not have the ability to decide. Substitute decision-makers
can be more than one.
Codes of ethics for advanced care directives
In order to ensure that the directives are structured properly and appropriately there are
certain codes of ethics which have to be followed. They are established on regard for an
individual's independence and are centered towards the individual. Able grown-ups or
independent people are qualified to settle on their own choices about close to home and
wellbeing matters (Wilson, Ingleton, Gott, & Gardiner, 2014). Self-rule can be practiced in
various ways as indicated by the individual's way of life, background, history and religious
convictions.
Grown-ups are assumed skillful to make their own decisions. Bearings in the directives
may refer to a wide idea of wellbeing and can relate with any future time. The individual chooses
what comprises personal satisfaction. The substitute person making decisions has a similar
expert as the individual if competent and must respect leftover basic leadership limit of making
decisions. Essential basic decision-making standard for substitutes has substituted judgment and
should possibly put together his or her choice with respect to the best advantages when there is
no proof of the individual's inclinations on which to base a substituted judgment.
Any care directive can be depended upon in the event that it seems legitimate. A refusal
of wellbeing related mediation in a substantial directive must be pursued whenever proposed by
the individual to apply to the circumstance. An individual, or their lawfully perceived substitute,
can agree to treatment offered, deny treatment offered, yet can't request treatment on their own.

HEALTHCARE ANALYTICAL ESSAY 8
A legitimate directive that communicates inclinations or refusals significant and explicit to the
current circumstance must be pursued.
The best application of advanced care planning in residential aged care facilities
These facilities have promptly available composed strategies and methodologies about
advanced care planning, with it as a normal part of care and provision. Adequate training on this
type of care arrangements is given to aged care staff, general professionals, relatives, and
residents. Patients of these residential facilities and families are given data with respect to propel
the plans at admission or before.
Advance care planning is offered to occupants first 28 days of affirmation. A skilled
healthcare professional completes the advanced health care amid an inside and out talk with the
occupant or potentially their family. The discussion centers around sensible results and "living
great", raising the issues of life-prolonging treatment without concentrating on a particular
treatment.
General practitioners are engaged with any advanced care planning dialogs. These
completed plans are routinely inspected. The documents and archives obviously determine: an
assigned substitute where pertinent, the present condition of wellbeing, qualities, and
convictions, future unsatisfactory wellbeing conditions, a dimension of favored restorative
treatment showed, a particular needed or undesirable medications, objectives for the finish of life
care, fitting marks, proof of general practitioners survey. The residential facilities have
successful data exchange frameworks that empower correspondence of development care
arranging data to other medicinal providers of the services.
The best decision-making process for a patient with an Advanced Care Directives

HEALTHCARE ANALYTICAL ESSAY 9
Evaluate the ability to settle on the choice required if substitute choice is required to
continue to stage 2. Set up whether inclinations applicable to the circumstance have been
recently communicated as directives or in past discourses. Wellbeing-related choices should
consider clinician exhortation about treatment alternatives and likely results in light of the
individual's desires, including intercessions, considered excessively oppressive and avoidable
results. Respect to explicit refusals of therapeutic medicines and intercessions whenever
expected to apply to the present conditions should be observed. Give a specific load to different
inclinations and bearings in the directives significant to the present choice (McMahan et al,
2013).
When there are no particular pertinent inclinations and directions counsel with others
near the individual to decide important recently communicated perspectives and social or
relationship factors the individual would consider in basic decisions. Individual's known qualities
should be considered, life objectives, and social, semantic, profound and religious inclinations,
and plan to settle on the choice that the individual would make with a similar data and
exhortation. In a situation where a few treatment choices fulfill these decision-making criteria,
pick the least prohibitive choice that best guarantees the individual's legitimate consideration and
security. Residential choices ensure they consider in the case of existing casual game plans for
the individual's consideration are satisfactory and the attractive quality of not exasperating those
courses of action. Where there is no proof of what the individual would have chosen, settle on
the choice that best secures the individual's personality (Sudore, & Fried, 2010).
Issues associated with advanced care planning or directives
Advanced care directives may contain restorative headings that are clueless, too explicit
to consider accounting for changes in medicinal treatment or too non-explicit to direct the basic

HEALTHCARE ANALYTICAL ESSAY 10
making of decisions. Substitute decision makers are befuddled about their job and unsupported in
the basic making of decisions. Individuals change their inclinations after some time yet neglect
to refresh their advanced care directives. Clinicians don't pursue the headings in advanced care
directives or regard the basic leadership of the substitute.
Hindrances to making advance mandates are also observed such that: Numerous
specialists think that it's hard to chat with patients about end-of-life issues, bringing about
deferrals in the discourse until the death of the resident is imminent. Standardization of the talk is
important. National Framework for Advance Care Directives suggests that data about the
arrangement of advanced care and advanced directives ought to turn into a normal piece of
patient contact with professionals in wellbeing and mature consideration. Setting up the patient's
social qualities and the foundation is a significant piece of the development care arranging
dialog.
Numerous patients of minority social and language foundations are more averse to finish
advanced care directives than the larger part population. For certain societies, the standards of
self-governance and individual basic leadership on which advanced care directives are based are
very foreign (Billings, 2012). Another barrier to making directives is time. The exchanges
required for powerful and thorough development care arranging frequently don't fit perfectly into
the length of a standard meeting. In any case, with suitable arranging and discourse with the
patient, arrangements can be planned to enable the directives to be finished in time. When the
issue is brought up in an auspicious manner, at that point, for the most part, there is no
requirement for earnestness. In a situation where nursing staff aid wellbeing evaluations and the
executive's plans, preparing in the region of directives ought to be accommodated for nursing
staff to encourage their consolidation into routine appraisal and the planning of the management.

HEALTHCARE ANALYTICAL ESSAY 11
Strategies to improve the palliative care provision in residential aged care
There are different strategies which can be accessed in Australia's websites about the
aged care advanced plans to ensure the consumers benefit fully. The staff's skills, confidence,
and knowledge through training on some basics in advanced care directive or planning and the
palliative care should be increased. This ensures that the nurses don’t wait too long for the
decision-making planning until it is late and the patients are nearly dying (Kelley, 2013). The
residents should decrease the in hospitals exchanges and transfers when the patients are in the
last days of their lives. This makes insurance that the patients are settled and they can make their
own decisions without even involving the decision makers. Local resources and services should
be communicated earlier just to create awareness in advance. The residents should be
encouraged to complete their advanced care plans and directives when there is a profession or an
expert to help where necessary (Chan, Webster, & Bowers, 2016). Improving the continued care
between services and services delivery is necessary, when there is any change in the status of the
wellbeing of the patient or resident then a review should be done of the advanced care directives
and any plans available. A computerized reminder should be also set for other preventive
palliative care precautions. Insurance of documentation and any transfers of the information of
the resident should be observed. The substitute decision-maker should have a copy of the
advanced care directives or plan in case it is required urgently (Goddard, Stewart, Thompson, &
Hall, 2013).
Conclusion
In conclusion, residential aged care is one of the best ways to cater for those in advanced
age and in the last days of their lives. It is a center of care for the residents, families and the
caregiver's chance playing a very big role in emotional support. The advanced care planning and

HEALTHCARE ANALYTICAL ESSAY 12
directives make it respectful and honoring for the patients at their last days ensuring that their
dignity is upheld. Majority have clear inclinations with respect to end-of-life care; practically
these inclinations every now and then are not pursued. Advanced care directives enable
individuals to record their inclinations in advance of any loss of basic making of decisions
capability. The chance to make an advanced care plan or directive ought to be offered to
everybody as a major aspect of schedule social insurance, well ahead of time of any requirement
for the residential care. Therefore, proper utilization of time and resources benefits the residents
and they live happy last days.

HEALTHCARE ANALYTICAL ESSAY 13
References
Bigby, C., Bowers, B., & Webber, R. (2011). Planning and decision making about the future care
of older group home residents and transition to residential aged care. Journal of
Intellectual Disability Research, 55(8), 777-789.
Billings, J. A. (2012). The need for safeguards in advance care planning. Journal of general
internal medicine, 27(5), 595-600.
Brinkman-Stoppelenburg, A., Rietjens, J. A., & van der Heide, A. (2014). The effects of advance
care planning on end-of-life care: a systematic review. Palliative Medicine, 28(8), 1000-
1025.
Chan, R. J., Webster, J., & Bowers, A. (2016). End‐of‐life care pathways for improving
outcomes in caring for the dying. Cochrane Database of Systematic Reviews, (2).
Chan, R. J., Webster, J., & Bowers, A. (2016). End‐of‐life care pathways for improving
outcomes in caring for the dying. Cochrane Database of Systematic Reviews, (2).
Dwyer, D. (2011). Experiences of registered nurses as managers and leaders in residential aged
care facilities: a systematic review. International Journal of Evidence‐Based
Healthcare, 9(4), 388-402.
Goddard, C., Stewart, F., Thompson, G., & Hall, S. (2013). Providing end-of-life care in care
homes for older people: a qualitative study of the views of care home staff and
community nurses. Journal of Applied Gerontology, 32(1), 76-95.

HEALTHCARE ANALYTICAL ESSAY 14
Kelley, A. S., Deb, P., Du, Q., Aldridge Carlson, M. D., & Morrison, R. S. (2013). Hospice
enrollment saves money for Medicare and improves care quality across a number of
different lengths-of-stay. Health Affairs, 32(3), 552-561.
Koren, M. J. (2010). Person-centered care for nursing home residents: The culture-change
movement. Health Affairs, 29(2), 312-317.
McKeown, J., Clarke, A., Ingleton, C., Ryan, T., &Repper, J. (2010). The use of life story works
with people with dementia to enhance person-centered care. International Journal of
Older People Nursing, 5(2), 148-158.
McMahan, R. D., Knight, S. J., Fried, T. R., &Sudore, R. L. (2013). Advance care planning
beyond advance directives: perspectives from patients and surrogates. Journal of pain
and symptom management, 46(3), 355-365.
Meron, T. (2014). The meaning of advance directives in the lives of people with advanced long
term conditions (Doctoral dissertation, University of Nottingham).
Ramsey, I., Corsini, N., Peters, M. D., & Eckert, M. (2017). A rapid review of consumer health
information needs and preferences. Patient education and counseling, 100(9), 1634-1642.
Richards, C. T., Gisondi, M. A., Chang, C. H., Courtney, D. M., Engel, K. G., Emanuel, L., &
Quest, T. (2011). Palliative care symptom assessment for patients with cancer in the
emergency department: validation of the Screen for Palliative and End-of-life care needs
in the Emergency Department instrument. Journal of palliative medicine, 14(6), 757-764.

HEALTHCARE ANALYTICAL ESSAY 15
Stewart-Archer, L. A. (2012). Impact of the place of residence, expectations from life, depressive
illness, self-determination, and end of life care on the self-rated quality of life of adults
65 years and older living with Alzheimer's disease and other dementias. TUI University.
Sudore, R. L., & Fried, T. R. (2010). Redefining the “planning” in advance care planning:
preparing for end-of-life decision making. Annals of internal medicine, 153(4), 256-261.
Wilson, F., Ingleton, C., Gott, M., & Gardiner, C. (2014). Autonomy and choice in palliative
care: time for a new model?. Journal of advanced nursing, 70(5), 1020-1029.