Background Dementia is the second leading cause of death in Australia. However, people living with dementia often miss out on the opportunity to discuss advance care planning (ACP) and access palliative care.
Frontline aged and primary care staff are well placed to initiate ACP discussions with people living with dementia. However, many staff report a lack of confidence and skills in ACP and palliative care for people living with dementia.
The Advance Project Dementia is funded by the Australian government and aims to improve aged and primary care staff confidence, capacity and skills in ACP and assessing palliative care needs of people living with dementia.
Methods A literature review, environmental scan, input from an expert advisory group and extensive stakeholder engagement informed the development of a dementia-specific model and guide for initiating ACP and palliative care needs assessment at various levels of cognitive capacity, a suite of practical resources and online training to explain how to use the resources in everyday practice. Stakeholder interviews were held with 56 participants across Australia, including people living with dementia, family members, general practitioners, aged and primary care nurses, aged care providers and peak bodies.
Results The toolkit and online training are freely accessible and being disseminated to aged and primary care organisations across Australia. A train-the-trainer program is available to support implementation of the toolkit by aged and primary care organisations as part of routine practice. An evaluation is being conducted with train-the-trainer participants and a subset of implementation sites to inform ongoing quality improvement of the program.
Conclusion The Advance Project Dementia www.theadvanceproject.com.au/dementia provides a suite of dementia-specific training and resources that aim to make it easier for aged and primary care professionals to initiate courageous end-of-life conversations and assess palliative care needs of people living with dementia, to enable better care.
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