Palliative care in residential aged care

The Australian Government subsidises residential aged care services for older Australians whose care needs are such that they can no longer remain in their own homes. Residential aged care services provide accommodation and services to people who require ongoing health and nursing care due to chronic impairments and a reduced degree of independence in activities of daily living. They provide nursing, supervision or other types of personal care required by the residents.

Data downloads

Palliative care in residential aged care tables 2016-17 (500KB XLS)

Palliative care in residential aged care section 2016-17 (246KB)

The information in this section was last updated in October 2018.

Key points

  • There were about 239,600 permanent residents in Australia in 2016–17 with completed ACFI appraisals, and about 1 in 50 of these residents (4,509) had an ACFI appraisal indicating the need for palliative care.
  • The proportion of ACFI appraisals indicating palliative care within aged care facilities increases with the age of the resident.
  • The population rate of appraised need for palliative care among permanent residents was highest in Inner regional areas (33.6 per 100,000 population) followed by Outer regional (16.9) and Major cities (15.4).
  • Around 3 in 10 (29.4%) of permanent residents with an appraised need for palliative care had been diagnosed with cancer. The types of cancer most often recorded were Lung cancer (19.1%) and Colorectal (bowel) cancer (14.2%).

Residential aged care services face particular difficulties in administering palliative care, because permanent residents often have dementia and/or communication difficulties and complex care needs (AIHW 2018). In addition, there is a high burden of chronic disease and comorbidity in the residential aged care population (Hillen, Vitry & Caughey 2017).

Palliative care provided in a residential aged care service is regulated under the Aged Care Act 1997, within the Quality of Care Principles. Under the schedule of specified care and services, an Approved Provider is responsible for providing access to a qualified practitioner from a palliative care team, and the establishment of a palliative care program including monitoring and managing any side effects for any resident that needs it. In addition, under Schedule 2 – Accreditation Standards, an Approved Provider is responsible for ensuring the comfort and dignity of terminally ill care recipients is maintained.

The AIHW’s National Aged Care Data Clearinghouse contains information gathered via a number of data collections. Data collected from the Aged Care Funding Instrument (ACFI), which is used to determine the level of Australian Government subsidies care for permanent residents, has been used for the analyses presented here. Permanent residents who have been appraised as requiring palliative care under the ACFI and are receiving palliative care funding are included in the ‘palliative care’ group described in this section. In practice, it is possible to receive palliative care in residential aged care without having received an ACFI assessment indicating the need for palliative care. Also note that the data available to the AIHW cannot confirm the extent or nature of palliative care actually provided for those who were assessed and funded for palliative care.

It should be noted that the decrease over time in residential aged care permanent admission and residents appraised as requiring palliative care is most likely related to changes in the application of the Aged Care Funding Instrument (ACFI) for palliative care in recent years.