The Palliative and End-Of-Life Care Framework – Last 12 Months Of Life has recently undergone an update, including a name change to Prompts for End-of-Life Planning (PELP) Framework.
The PELP Framework guides proactive, quality end-of-life care across all care settings.
Implementation of the PELP Framework can help health professionals to provide quality person-centred care in the last 12 months of life. It invites health professionals to identify patients at risk of deteriorating and dying to trigger comprehensive discussions regarding the person’s goals and wishes for care. These ongoing discussions enable the preparation of person-centred management plans that align with the person’s wishes and reduce the need for decision making in emotionally charged situations.
The PELP Framework contains prompts that support:
- Identification of patients suitable for a palliative approach to care
- Ask the surprise question: ‘Would you be surprised if the person died in the next twelve months? This can be answered by intuition, using clinical and personal knowledge of the patient, and/or clinical tools (e.g. SPICT).
- Identification of four clinical end-of-life processes:
- Advance care planning and person-centred care based on need (at risk of dying)
- Transition focus of care needs from restorative to palliative (likely to die soon)
- Terminal care needs (dying)
- After-death care (bereavement).
How the PELP Framework was developed
caring@home convened a national Advisory Committee, with General Practitioners, Palliative Medicine Specialists, Nurse Practitioners and Nurses to review the existing Palliative And End-Of-Life Care Framework – Last 12 Months Of Life.
The Committee had representatives from the following organisations:
- Australian College of Nurse Practitioners (ACNP)
- Australia New Zealand Society of Palliative Medicine (ANZSPM)
- Blue Care - Queensland
- Brisbane South Primary Health Network (BSPHN)
- Northern Territory Primary Health Network (NTPHN)
- Palliative Care Australia (PCA)
- Rural Doctors Association South Australia (RDASA)
- The Royal Australian College of General Practitioners (RACGP)
Resources supporting use of the PELP Framework
Colour Key: Outlines helpful resources that can be used across the trajectories of the PELP Framework.
* Advance Care Planning (ACP) and person-centred care based on need
* Transition focus of care needs from restorative to palliative
* Terminal care needs
* After death care
| PELP Section |
Title |
Description |
|
Identification of deteriorating patient
* * *
|
SPICTTM
|
Supportive & Palliative Care Indicators Tool (SPICTTM) helps identify people with deteriorating health due to advanced conditions or serious illness.
|
| CareSearchgp App |
The CareSearchgp App offers palliative care information and prescribing guidance to support quality care at end of life
and recognising end of life. |
|
Advance Care Planning
* * *
|
ACPATM
|
Advance Care Planning AustraliaTM is a national project enabling Australians to make the best choices for their future health and care.
Learn about the process for creating an advance care plan in your state. |
| QUT End of Life Law in Australia |
This webpage discusses the laws on Voluntary Assisted Dying (VAD) both in Australia and internationally, and their intersection with palliative care and medical treatment decision-making. |
|
Medicines
* * *
|
palliMEDS app |
The palliMEDS app familiarises primary care prescribers with eight palliative care medicines that have been endorsed by the Australian & New Zealand Society of Palliative Medicine (ANZSPM) for management of terminal symptoms. The ANZSPM-endorsed medicines can be used to manage common emergent symptoms in home-based palliative care patients in the last few weeks of life when people often have problems swallowing. |
| Core Medicines |
The National Core Community Palliative Care Medicines List (the List) identifies four medicines for use by home-based palliative patients in the terminal phase who require urgent symptom relief. |
|
Supporting carers
* * *
|
Gather My Crew app |
Set up a 'support crew' with the free Gather My Crew app to coordinate family and friends to help with meals, laundry, grocery pickup or social visits. |
| HELP App |
The HELP App can assist to coordinate the social and practical support that people need when receiving palliative or end-of-life care. |
| caring@home |
caring@home aims to increase access to quality and timely end-of-life care for patients who choose to be cared for, and die at home, if possible. |
|
Education opportunities
* *
|
PEPA and iPEPA |
PEPA Education provides free health placements in palliative care services and free palliative approach workshops. |
|
Goals of care
* * *
|
Australian Commission on Safety and Quality in Health Care |
Identifying goals of care: Tips for clinicians - a Comprehensive Care Standard |
|
Bereavement
* *
|
Services Australia |
What to do when a loved one dies
- Following the death
- Registering the death
- Organising the funeral
- Using the death certificate
- Finalising an estate
- Looking after yourself |