Clinical Resources

• ClinEdAus offers information and strategies for supporting health professional learners or students to develop their clinical decision-making skills.
• Critical Thinking and Clinical Reasoning (892kb pdf) from Krozier and Erb’s Fundamentals of nursing (2016) describes the components of clinical reasoning and strategies to enhance critical thinking and clinical reasoning as the provider of nursing care.
• Visit the information and videos on ClinEdAus website.
• Visit Australian College of Nursing – Thought Leadership – critical thinking.

• Medline Plus (US) has a Herbs and supplements page that allows you to browse through dietary supplements and herbal remedies to learn about them.
• Cancer Australia has information on Complementary and alternative therapies and Questions to ask a complementary health practitioner.
• The Cancer Council NSW has resources for consumers on Complementary therapies.
• Complementary medicines and the Australian regulatory guidelines for registered complementary medicines (ARGRCM) from Therapeutic Goods Administration provides general information on how complementary medicines are regulated.

Evidence for Medications

• Read the Australian Prescriber article Rational prescribing in community palliative care. This looks at managing the palliative care of everyone and covers symptom management as well as deprescribing.

Palliative Medications

• For information relating to the prescribing and dispensing of medication in preparation of need read Anticipatory medicines: State-wide guidance for Victoria (1.11MB pdf).
• Syringe driver compatibility Guidance Document (689kb pdf), Safer Care Victoria have produced this document to provide a quick reference to drugs that are compatible in the syringe driver.

The Role of the Carer

• Marie Curie, UK provide information relating to Managing symptoms.
• To keep track of what medications are being taken you can use the palliAGED Medicines Form (88kb pdf).
• For those who have a carer involved in assisting with medications, the Injections and Syringe drivers fact sheet (367kb pdf), by CarerHelp gives and overview.
• The Medication Template & Handling Medicines (838kb pdf), template by CarerHelp, gives a place to document what has been taken. This may help to reduce medication errors and highlight the need for medication reviews.
• Marie Curie UK provide, Managing pain – a guide for people living with a terminal illness. This is available in booklet form or as a PDF.
• From the Department of Health, Disability and Ageing: Guiding principles for medication management in the community provides an overview of 12 guiding principles for medication management.
• From Palliative Care Victoria offer a booklet: Supporting a person who needs palliative care: A guide for family and friends. This can be downloaded as a PDF or ordered by downloading the form.

• Deterioration in Parkinson’s Disease (633kb pdf) from the Southern Metropolitan Palliative Care Consortium
• The Southern Metropolitan Palliative Care Consortium has also developed a guide Parkinson’s Disease – Issues for the palliative care team (722kb pdf).
• Parkinson’s Disease – Issues for the Aged Care Team (878kb pdf) from the Southern Metropolitan Palliative Care Consortium
• For clients with motor neurone disease:
  • End of life care: A guide for people living with MND (3.6MB pdf), MND Australia
  • Planning ahead, MND Australia.
• The Gold Standards Framework (UK) has developed a Proactive Identification Guidance (2022) that may be helpful to recognise earlier when a patient is nearing end-of-life.
• The National Health and Medical Research Council (NHMRC) provides and An ethical framework for integrating palliative care principles into the management of advanced chronic or terminal conditions (594kb pdf). Canberra: NHMRC; 2011 Sep.
• Information from the Deakin University Barwon Health Partnership
  • Revised Guidelines for Deciding Palliative and End of Life Care with People with Diabetes 2019
  • Palliative and end of life care: information for older people with diabetes (6.28MB pdf)
  • Palliative and end of life care: information for families caring for older relatives with diabetes (7.54MB pdf)
  • Planning palliative and end of life care with older people with diabetes: information for health professionals (3.77MB pdf)

• The Palliative Care Network of Wisconsin Fast Facts and Concepts page #396 Psychosocial Assessment in Palliative Care outlines a structured psychosocial assessment.
• The Marie Curie (UK) website has information and practice tips relating to Communication and providing emotional care and related topics in the Palliative Care Knowledge Zone.
• Videos from UCSF School of Medicine discuss:

• 4 key areas to focus on with psychosocial support: non-abandonment, hope, bringing closure to important relationships, and spirituality (doctor focus but relevant for other health professionals)
• screening for distress and the role of a social worker.
• End-of-life Essentials modules provide examples of nurses supporting people with advanced illness. They include examples of conversations and tips on how to optimise these interactions.
• In the CareSearch Community section, Living with illness provides information resources and practical tips to support patients, families, and carers.
• The Marie Curie (UK) website has information to optimise daily life for people living with a terminal illness (for patients, families, and carers).
• Guide patients, families, and carers to the communication resources in the CareSearch Community section.

• Deterioration in Parkinson’s Disease (633kb pdf) from the Southern Metropolitan Palliative Care Consortium.
• The Southern Metropolitan Palliative Care Consortium has also developed a guide Parkinson’s Disease – Issues for the palliative care team (722kb pdf).
• Parkinson’s Disease – Issues for the Aged Care Team (878kb pdf) from the Southern Metropolitan Palliative Care Consortium
• The SPICT (Supportive & Palliative Care Indicators Tool) website hosts the SPICT and SPICT-4ALL tools and related resources to guide conversations about care planning.
• CareSearch interactive versions of the SPICT (571kb pdf) and SPICT4ALL (571kb pdf) forms for online use.
• ELDAC website has resources for responding to deterioration of older people in residential aged care, home care and primary care settings.
• PCOC model recognises deterioration as an element of person’s life-limiting illness. The PCOC tools help assess and monitor the characteristics and needs of patients:

• Symptom Assessment Scale (SAS)
• Palliative Care Problem Severity Scale (PCPSS)
• Australia-modified Karnofsky Performance Status (AKPS) Scale
• Resource Utilisation Group – Activities of Daily Living (RUG-ADL).
• The GSF Proactive Identification Guidance is a practical guide for clinicians enabling earlier recognition of decline for patients considered to be in their final year/s of life.
• The CareSearch Clinical Evidence Summary Recognising last years of life discusses disease trajectories and identifying that a person has palliative care needs.

• For information relating to spirituality, visit palliAGED and read the ‘Spiritual care’ Practice Tip Sheet.
• The Centre for Cultural Diversity and Ageing offer practice guides. See the Spiritual Support guide (571kb pdf).
• To learn more about Understanding Spiritual Needs, the PCC4U module helps you to recognise the importance for meeting holistic needs and providing person-centred care.
• Palliative Care Australia and Meaningful Ageing Australia, provide a joint position statement on spirituality in aged care (466kb pdf). This provides and affirmation and a call for action.
• For insights into the domains of spiritual care, read Meaningful Ageing Australia: The National guidelines for spiritual care in aged care (2016).
• From Public Health England a report: Faith at end of life, 2016. This resource aims to help frontline professionals maintain a holistic approach to the people in their care.
• Listen to Professor Rod MacLeod, talk about the place of spiritual care at the end of life.
• The European Association for Palliative Care (EAPC) taskforce has a white paper on multi-disciplinary education for spiritual care in palliative care that provides a guide for health care professionals involved in teaching or training in palliative care.
• See CareSearch’s Living with illness resources for patients and carers for more resources in spirituality.

Symptom management resources.

• The Guidelines for Subcutaneous Infusion Device Management in Palliative Care and other settings (4.68MB pdf) (Queensland Health) offer evidence-based guidelines to inform practice, develop policy, procedures, training and education programs in relation to the use of a portable subcutaneous infusion device in palliative care and other settings.
• The syringe driver compatibility guidance document (Safer Care Victoria) provides advice on specific subcutaneous medications and practice guidance in relation to the two-medication and thee-medication compatibility of opioid and non-opioid medications.
• The free online syringe pumps learning packages (intermediate to advanced level) from PallConsult Queensland include a handbook, a step-by-step guide, videos and a competency checklist.
• Queensland Health offers online learning on Management of Subcutaneous Infusions in Palliative Care
• WA Department of health has published a one-page guidance for Medication compatibilities for subcutaneous infusions (137kb pdf).
• The Marie Curie (UK) website has information and practice tips relating to Syringe drivers in palliative care.
• caring@home offers information, learning modules and links to resources relating to subcutaneous medicines for health professionals and families and carers.
• The Marie Curie (UK) website has information on syringe drivers (for patients, families, and carers).

Family meetings

• To learn more about family meetings, the palliAGED website provide pages. See the ‘Case Conferences’ palliAGED Practice Tip Sheet or Download the palliAGED Forms for palliative care Case Conferences.
• There is a PCC4U module that includes a section on Family meetings. See module 4, activity 5 to understand the role of family meetings.
• The Centre for Palliative Care Education and Research (CPCER) provide the resource Family meetings in palliative care: multidisciplinary clinical practice guidelines (2009) (258kb pdf). This has useful tools for pre-meeting and documentation to support the process.
• The Department of Health provide Multidisciplinary case conference Medicare Items for GPs (whereby GPs can claim MBS Primary Care items).
• The SPIKES protocol is a six-step guide for holding family meetings in which difficult decisions need to be made.

Supporting carers

• CarerHelp provides practical information and resources for carers of people with palliative care needs.
• caring@home provides education and resources for you and your care nurse on administering subcutaneous medications.
• The Advance Project is an evidence based toolkit and training package to better primary health care through team-based initiation of advance care planning and palliative care.
• The International Palliative Care Family Carer Research Collaboration (IPCFRC) has resources to promote research into evidence-based support for family carers of palliative care patients.
• Carers Australia is a national advocacy body that provide local support networks for carers to improve health, wellbeing, resilience and financial security.
• CareSearch has the Carer Needs Assessment Tool to help carers identify where they need support.
• The Carers Alert Thermometer (CAT) is a short screening tool to identify and support the needs of unpaid family carers providing end of life care at home. It has been developed with carers and professionals in the UK to ensure it is evidence-based and assesses the most important areas of carer burden. It is available free of charge.
• Read the European Association for Palliative Care (EAPC) Part 1. EAPC White Paper on improving support for family carers in palliative care (2010) (301kb pdf). This paper outlines the roles and needs of carers and makes recommendations for their support.
• Read the European Association for Palliative care (EAPC) Part 2. White Paper on improving support for family carers in palliative care (2010) (156kb pdf). This paper outlines the types of support that is offered to family carers and highlights future challenges in areas of service provision.
• To help you arrange a family meeting or case conference, the palliAGED website has a series of Palliative Care Case Conference Forms for your practice.
• From the Agency for Clinical Innovation video series, listen to Dr Jenny Broadbent talk about caring for carers.