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Scoping Review Summary

Background and aims

The primary goal of palliative care is to optimise the quality of life and to address physical, emotional, spiritual, and social symptoms and issues. [1] Palliative care provision in the context of older age and aged care services needs to acknowledge specific issues and contexts. [2-4] To understand the scope of the palliative and end-of-life care research in aged care, we carried out a scoping review to find systematic reviews on the topic. We then compared reviews to identify the major themes discussed across the literature.

Our method

A search strategy was created in Ovid Medline and then translated for CINAHL, Embase (Ovid), PsycINFO, and Scopus. The search strategy included a wide range of terms covering multiple aspects of palliative and end-of-life care and was limited to English-language systematic reviews published since 2012. All database searches were run on 8 September 2022. A librarian assisted by conducting a search for grey literature on the topic, as well as iterative searches of Google Scholar. All citations retrieved were uploaded into Covidence for dual screening. Titles and abstracts were screened first, followed by full-text articles for those items thought to be relevant, or where the two reviewers were not in agreement on eligibility. 
Reviews were considered relevant if they described palliative or end-of-life care in older populations living in the community and receiving home care, or those living in residential aged care. They also needed to provide evidence of a systematic search process and some form of critical appraisal of their included studies. 

Our findings so far

The searches retrieved 2331 citations to reviews for screening. From these, 86 have been judged relevant to the topic and the aged care context. Some of the most commonly occurring themes across this literature are: 

  • Advance care planning
  • Acute care transfers
  • Staff palliative care training and education 
  • Care of the person with advanced dementia at the end of life
  • End-of-life communication. 

These themes are currently being written into evidence themes for this priority topic. An Evidence Advisory Group has been convened to offer guidance on the scope of these themes and to critically review each one prior to its publication. 

  1. Palliative Care Australia. National Palliative Care Standards. 5th ed. Canberra: PCA; 2018.  
  2. Llop-Medina L, Fu Y, Garcés-Ferrer J, Doñate-Martínez A. Palliative care in older people with multimorbidities: A scoping review on the palliative care needs of patients, carers, and health professionals. Int J Environ Res Public Health. 2022 Mar 8;19(6):3195.
  3. Parker D, Lewis J, Gourlay K. Palliative care and dementia. Canberra: Dementia Australia; 2018. (Dementia Australia paper; no. 43)
  4. Nicholson K, Makovski TT, Griffith LE, Raina P, Stranges S, van den Akker M. Multimorbidity and comorbidity revisited: Refining the concepts for international health research. J Clin Epidemiol. 2019 Jan;105:142-146.