Why greater investment in palliative care could lead to economic benefits

The potential savings on medical costs could make a big difference for relieving pressure on Australia’s health systems and residential facilities, says Ben O’Mara.

The new Aged Care Standards recently released by the Australian Government could have helped reduce the costs of end-of-life support and help more elderly people deal with a terminal illness, but did not mention the role of palliative care in aged care facilities. The omission is a lost opportunity.

According to Palliative Care Australia, 35 per cent of all deaths in Australia occurred in residential aged care between 2014-15. Of all the permanent residents who died, only a small number received a formal assessment noting that they required palliative care.

Palliative care can make a big and positive difference to the lives of elderly people and their families and carers, helping them live more fully and as comfortably as possible until death.

What may be less known is that palliative care has major economic benefits, too. Specialist palliative care services have resulted in less spending on medical treatment, and other associated costs. The savings from palliative care could help to reduce pressure on Australian aged and healthcare systems, while better supporting the elderly.

Greater investment in palliative care may be essential for more cost-effective, medically sound and compassionate end-of-life care in Australian aged care facilities.

How does palliative care improve quality of life in aged care?

Generally, palliative care involves being sensitive to the needs of patients and those providing them with support. Nurses, physicians and other health professionals provide palliative care, at home, in hospital and in residential aged care settings.

Elderly people with a terminal illness who are in residential aged care are likely to require multiple kinds of physical and psychological assistance. Finding ways to relieve pain, lack of appetite, anxiety, sleeplessness, fatigue, vomiting, cough and shortness of breath are important. Advice and support when taking medications like opioids helps to control pain and make daily life easier and less distressing.

A holistic, patient focused approach to care is also important. A holistic approach helps to meet the emotional, social, spiritual and cultural needs of patients and their families.

Despite the many benefits of palliative care, it’s not easy to access in residential aged care. Residential aged care has not previously been recognised as a site of palliative and end-of-life care, with related developments having only occurred in recent years.

Lack of access to appropriate palliative care specialists, complex medical conditions and little awareness of help available have contributed to low use of palliative care services too – although knowledge of the need for more palliative care services is growing.

The economic benefits and potential

In one study, the cost-savings associated with the reduction in hospital bed days equated to an average of $2,955 per patient.

Recent research in Ireland found that after the implementation of end-of-life care in three nursing homes, the overall costs of support associated with hospitalisation and ambulance transfers were reduced. Analysis of the research findings suggested that there would be large annual savings if the results were extrapolated to similar facilities across Ireland.

Australian research also demonstrates economic benefits from the use of specialised palliative care services in residential aged care services. The prevention of unnecessary hospital transfers and stays leads to major reductions in medical costs. In one study, the cost-savings associated with the reduction in hospital bed days equated to an average of $2,955 per patient.

More study on the economic benefits of palliative care in Australia is required. The potential savings on medical costs, however, could make a big difference for relieving pressure on Australia’s health systems and residential facilities. Greater efficiency in health systems can help redirect financial resources so that more people benefit from help available.

What’s also highly beneficial is that palliative care helps to better meet the needs of aged care residents, as well reducing medical costs. The investment in palliative care staff and services has helped improve the management of pain, and levels of comfort, during a very difficult time of life.

The goal of palliative care is not cost-cutting. Rather, palliative care seeks to improve the challenging and painful conditions of dying for the elderly, and their family and friends, with high-quality support, dignity, and respect.

Ways to help increase access to palliative care

“It seems rare in Australia that an opportunity to improve the lives of so many people affected by a complex health issue is both compassionate and economically beneficial.”

The current Aged Care Quality Standards come into effect on 1 July, 2019. Updating the standards so that they include reference to palliative care services will help to embed their role in providing quality aged care across Australia.

Unfortunately, updating the standards is only one part of helping more elderly people access palliative care services. Increased funding for palliative care provision is needed. More training of aged care services staff will help them respond appropriately when palliative care is required.

More targeted research into the experiences of residential aged care facilities, Australian families and carers when providing end-of-life support and its economic impact on their lives will also help to identify ways of relieving financial stress.

And here is an opportunity to be guided by the evidence and invest in palliative care services for aged care so that more Australians find relief from the pain and stress of an advanced disease now, and in future.

This article was originally published in the Mandarin. Ben O'Mara is as an Adjunct Research Fellow in Media and Communications, Faculty of Health, Arts and Design at Swinburne University. He also works as a freelance writer based in Canberra and Melbourne, Australia.