A palliative care case conference provides an opportunity to coordinate and plan care for a person who may be in the last months of life.
Changing care needs, symptom concerns, family issues and the need for coordination among providers can also signal the need for a case conference.
Indicators for a Palliative Care Case Conference
A palliative case conference is recommended for older people who the healthcare team estimates have a prognosis of six months or less to live.
One of the first indicators that can provide guidance on when to consider a palliative care case conference is the simple screening question called the 'The Surprise Question':
‘Would I be surprised if the person dies within the next six months?'
If you wouldn't be surprised if the person died in the next few months, consider a case conference.
If the answer to this question isn’t clear, then other things that may prompt consideration of a case conference include:
- Sudden decline or deterioration in the older person’s health.
- The older person wishes to clarify how their care needs will be met if they get sicker.
- The older person and/or their substitute decision maker express a wish to seek comfort care rather than curative disease management.
The Supportive and Palliative Care Indicators Tool (SPICT) (298kb pdf) can be used to help identify people whose health is deteriorating.
A palliative care case conference is a meeting between an older person and/or their family and the care providers.
The aims of a palliative care case conference are to:
- Identify clear goals of palliative care for the older person.
- Review any advance care plans for changes.
- Provide a safe environment where issues and questions about end-of-life care can be raised.
- Identify appropriate strategies for care provision and coordination.
Palliative care case conferences have demonstrated benefits for:
- Improving quality of life until death.
- Maintaining function for as long as possible.
- Significantly reducing hospitalisations.
- Increasing coordination of care.
- Facilitating information transfer between healthcare providers and family members or others involved in care of the older palliative person.
Sometimes there may be differing views about end-of-life care. Having everyone with a stake in an older person’s care
‘on the same page’ is vital to achieve the best outcomes for the older person and their families or friends.
GPs are an important part of care planning for older Australians. The GP may lead and organise the case conference or the GP may be a participant.
Wherever possible the person’s GP should be invited to attend a palliative care case conference. Even if the GP cannot attend, their role should be considered in any care planning.
If the GP cannot attend, consider also how the issues addressed in the case conference will be communicated to the GP.
Medicare requirements for funding of case conferences (182kb pdf) should be considered in planning.
Any triggers that have highlighted the need for a case conference should be carefully addressed during the case conference.
Page updated 04 December 2023