Step 2: Addressing Standard 5 and Outcome 5.7
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Step 2: Addressing Standard 5 and Outcome 5.7

The Aged Care Act embodies an older person’s rights including the right to equitable access to palliative care and end of life care. It emphasises the importance of advance care planning giving individuals a way to make decisions about their future health and personal care needs. It also outlines provider responsibilities.

Standard 5 describes the quality of clinical care older people can expect when receiving aged care services, wherever they are in Australia. This is a provider responsibility. Effective implementation of Standard 5 is reliant on the systems and processes from Standards 1-7. Outcome 5.7 addresses palliative care and end of life care.

Remember, care at the end-of-life needs to be person centred and should be evidence-based, clinically appropriate and timely.

Standard 5 Expectation statement for older people

I receive person-centred, evidence-based, safe, effective, and coordinated clinical care services by health professionals and competent aged care workers that meets my changing clinical needs and is in line with my goals and preferences.

Provider Responsibilities: Palliative care and end of life care

Providers have three main responsibilities with respect to Outcome 5.7. They are

  • To recognise and address the needs, goals and preferences of individuals for palliative care and end-of-life care and preserve the dignity of individuals in those circumstances.
  • To ensure that the pain and symptoms of individuals are actively managed, with access to specialist palliative and end-of-life care when required.
  • To make sure that supporters of individuals and other persons supporting individuals are informed and supported, including during the last days of life.

What needs to be in place?

Five sets of processes need to be in place:

  • Processes to recognise the need for palliative care, that support the person approaching the end of life and respond to changing needs.
  • Processes that facilitate end of life planning conversations, consider options and choices, and review advance care planning goals and documents.
  • Making use of comprehensive care processes to plan and deliver palliative care which recognise the importance of comfort and dignity, the person’s spiritual, cultural and psychosocial needs, assessment and management of pain and symptoms, shares information and involves specialist equipment and specialist services as needed and provides an appropriate environment for palliative care.
  • Communication so the older person and family are aware of end of life and have access to loss and bereavement information.
  • Care processes that recognise and respond to last days of life, ensure medications are available to manage symptoms, provide care that supports the person physically and minimises undesired transfers to hospitals.

Practical Actions

As a care provider, you need to understand your Service Category. Residential service providers have 24-hour responsibility for the clinical care needs of the people in their care. Home service providers need to have systems to manage risks to people receiving care that reflect how complex the person’s needs are, the type of service they provide and where they deliver care.

  • Regulation guidance indicates that Standard 5: Clinical Care applies to Registration Category 5 & 6. For Category 4, only Outcome 5.1 Clinical Governance applies to the service types of care management and restorative care management only.
  • Go to the Aged Care Commission’s Draft Strengthened Quality Standards Guidance. Use the filter to select your service categories and your clinical care to check your specific responsibilities.

Sensitive and timely conversations are needed. This can help establish if care needs are changing. Conversations support advance care planning and need to recognise the older person’s right to refuse advance care planning and to lead end of life planning. Comprehensive end of life care relies on effective communication with the older person and their family, supporters, and within and between health care providers and aged care staff and their services.

Early identification provides time to undertake planning and coordinate care. Risk prediction tools, trigger tools and questions can all be helpful in alerting you to changes that may indicate the person is entering the last months of life.

There is an expanding evidence base to support clinical care as people approach the end of their life. This evidence covers symptoms and symptom management, prescribing and multidisciplinary care.

  • palliAGED’s Evidence Centre provides a critical resource for aged care with summaries of evidence for practice on clinical and service issues associated with palliative care and end of life care. These issues are mapped to the strengthened standards.
  • You can also download an overview of evidence, education and clinical resources (XXXkb pdf) [New PDF] related to palliative care mapped to aspects of palliative care identified in Outcome 5.7.

Palliative care training prepares aged care staff to provide person-centred, holistic care, including symptom management, communication, and support for families and carers. Inhouse training can help staff feel more comfortable and confident in talking about end of life and providing care to people who are dying. Creating educational avenues for staff will help develop a more capable workforce who can support multidisciplinary care and provide compassionate and inclusive care.

  • Order palliAGED’s Practice Tips for Nurses and for Careworkers to support staff who are new to aged care or to palliative care.
  • Recommend staff complete palliAGED’s education modules or embed them in your own Learning Management System.
  • The Developing your workforce section has more ideas on how to ensure direct care providers and the broader multidisciplinary teams has needed skills and knowledge.

Signs that someone is nearing death include worsening illness, weight loss, and more severe symptoms.

Grief and bereavement are central to aged care, affecting older people, families, and staff. The quality of end-of-life care, including after-death care, can shape the grief experience of families and carers.

If an older person, their family or carers wishes to learn more about loss, grief or bereavement, these resources may help:


Page created 21 March 2025