End of Life Directions for Aged Care: supporting quality care for older people at the end of life

A blog post written by Distinguished Professor Patsy Yates and Karen Clifton from Queensland University of Technology (QUT)

ELDAC (End of Life Directions for Aged Care) aims to improve the quality of care for people in residential and community aged care settings. The project seeks to promote change enabling a reduction of avoidable hospital admissions, with shortened stays and improved quality of care for older Australians.

ELDAC has been funded since 2017 by the Australian Government Department of Health as a national specialist palliative care and advance care planning advisory service. The project and website (www.eldac.com.au) provide information, guidance and resources to support health professionals and aged care workers to care for older people who are at the end of life.

The project is delivered by a consortium that brings together three universities and five national bodies from aged care, palliative care and primary care. They are: Queensland University of Technology (QUT); Flinders University of South Australia (FUSA); the University of Technology Sydney (UTS); Palliative Care Australia (PCA); Aged & Community Services Australia (ACSA); Leading Age Services Australia (LASA); Australian Healthcare and Hospitals Association (AHHA); and Catholic Health Australia (CHA).

ELDAC aims to promote lasting change at the individual, service and system levels and comprises an innovative technology-based solution that can be delivered across these multiple levels. The intended outcomes of the project have been aligned with the project’s key objectives and include:

• The empowerment of general practitioners, aged care providers, and other healthcare workers with knowledge of palliative care and advance care planning relevant to their situation;
• The creation of links between primary care, aged care, and palliative care; and
• The provision of advice about palliative care, advance care planning, and advance care directive resources, processes, legislation and accountabilities in the state or territory in which the aged care provider, general practitioner, or other healthcare worker is located.

The first phase of the project ran from 2017 – 2020 with key achievements including:

•  An ELDAC website and five online toolkits;
• Twelve toolkit educational videos;
• Two COVID-19 webinars;
• Development of ELDAC Care Model and a common suite of clinical tools;
• Downloadable ELDAC resources including factsheets and posters;
• Development of a prototype digital dashboard (currently trialing with aged care IT providers); and,
• 70 aged care sites enrolled in sector engagement and partnership activities.

The second phase of ELDAC commenced in July 2020. This second phase has five workstreams:

Workstream 1 (Information and Advisory Services):

• A suite of capacity-building resources and access to a web-based navigation service via the ELDAC website will be maintained and enhanced;
• The five toolkits produced in the previous phase of the project will continue to be improved and updated to incorporate the latest evidence and changes in the field; and
• Three new toolkits will be developed to address priority needs and emerging issues.

Workstream 2 (Technology Solutions):

• The ELDAC digital dashboard rollout will continue, providing aged and primary care services with direct measures of palliative care and advance care planning in their service; and
• Additional technology-based tools, including a care worker app, an online self-care plan, and search filters and databases will be constructed.

Workstream 3 (Workforce Capability):

• A database of education activities relevant to the aged care workforce will be maintained, building on the Frameworks for developing health and aged care provider workforce capability established through the Palliative Care Education and Training Collaborative;
• Learning pathways guiding health and aged care providers to relevant learning resources will be developed; and
• Education and training activities will be designed to address identified gaps.

Workstream 4 (Service Partnerships):

• Local service networks will continue to be mapped to identify capacity in specialist palliative care and advance care planning in terms of knowledge, skills, and resources; and
• National linkage facilitators will continue to work with aged care/palliative care/primary care local partnerships and regional networks including Primary Health Networks to implement a range of evidence-based, sustainable linkage strategies using the ELDAC suite of resources.

Workstream 5 (System Capability):

• A series of evidence reviews will be conducted; and
• An engagement plan will be developed in consultation with Commonwealth, State and Territory government representatives to ensure that ELDAC activities are integrated within the existing activity.

To find out more about ELDAC, visit www.eldac.com.au or contact us at eldac.project@flinders.edu.au.

Distinguished Professor Patsy Yates QUT Lead and Project Director at Queensland University of Technology

Karen Clifton the National Project Manager for ELDAC at Queensland University of Technology