Palliative Care Australia (PCA) has welcomed new linked data released this week from the Australian Institute of Health and Welfare (AIHW), providing a national picture of older people's access to specialist palliative care.
The AIHW data, based on 132,000 people aged 65 and over who had predictable deaths (from illness) in 2021-22, indicates older people are typically first receiving specialist palliative care just 12 days before they die.
PCA CEO Camilla Rowland said the findings reveal complex patterns across aged care, hospital and community settings, but a very clear story about timing.
"The median time between a first specialist palliative care service and death was just 12 days. We know from the evidence that outcomes are better when people get early access to palliative care – at least 90 days before death," Ms Rowland said.
"Earlier access to specialist palliative care is associated with reduced hospitalisations, better symptom control and more supported decision-making. That gap represents lost time for comfort, planning and connection for older people and their families."
Given Australia will have a major increase in the 85 plus aged group over the next decade, the need for palliative care will only increase.
The data highlights particular concerns for people living in residential aged care, who are less likely to receive specialist palliative care, and more likely to receive it even closer to death, than people using home care or residential respite care.
"Older people in residential aged care often have complex conditions such as frailty and dementia, and they absolutely stand to benefit from palliative care," Ms Rowland said.
"Yet this data shows they are the least likely to receive specialist palliative care, and when they do, it comes even closer to death. Families want more than a week or two of help at the very end – they want time to understand what is happening, manage symptoms well, and share precious, unhurried moments together."
The AIHW notes that the report does not capture all palliative care activity in Australia, including some care delivered within residential aged care, in private hospitals, some community-based services and primary care. Even with these limitations, the patterns are striking, including high levels of unplanned hospital and emergency department use in the last year of life.
"The report confirms what many families and clinicians have been feeling for a long time – that palliative care is often introduced as a late response to dying, rather than a supportive approach to care over months," Ms Rowland said.
