AIM: People living with dementia are less likely to receive palliative care compared with people living with other terminal illnesses, and are at high risk of significant symptom burden at the advanced stages of disease. We aimed to evaluate the perspectives of senior staff working in Victorian residential aged care facilities (RACFs) regarding barriers and enablers to provision of optimal palliative care for residents with dementia.
METHODS: Cross-sectional survey distributed to all Victorian RACF senior staff in online and paper format from November 14 2022 to January 22 2023. Qualitative data were analysed using inductive thematic analysis.
RESULTS: Of 762 RACFs contacted, 147 responses were received (19.3% response rate). Respondents were primarily Facility Managers (43.8%), followed by Care Coordinators (21.2%) and Directors of Nursing (17.1%). Five themes were identified regarding barriers to provision of optimal palliative care: family acceptance of a palliative approach, General Practitioner involvement, access to necessary resources, staff knowledge and skills, and the complex trajectory of dementia. Additional specialised training for staff was highlighted as a priority action area. COVID-19 was frequently identified as impacting staffing, availability of supportive services, and access to time with loved ones.
CONCLUSIONS: Senior staff identified numerous barriers to residents with dementia receiving appropriate palliative care in their RACF. Further research is required to determine perspectives of other key stakeholders such as residents, carers and General Practitioners to inform change that addresses barriers and improves the quality of life and death of people living with advanced dementia.