title: Residential aged care: the last frontier for palliative care.
abstract: OBJECTIVE
  This paper is a report of an explorative study describing the perceptions and beliefs about palliative care among nurses and care assistants working in residential aged care facilities in Australia.
  
  
  BACKGROUND
  Internationally, the number of people dying in residential aged care facilities is growing. In Australia, aged care providers are being encouraged and supported by a positive policy platform to deliver a palliative approach to care, which has generated significant interest from clinicians, academics and researchers. However, a little is known about the ability and capacity of residential aged care services to adopt and provide a palliative approach to care.
  
  
  METHODS
  Focus groups were used to investigate the collective perceptions and beliefs about palliative care in a convenience sample of nurses and care assistants working in residential aged care facilities in Australia. Thematic content analysis was used to analyse the data, which were collected during 2004.
  
  
  RESULTS
  Four major themes emerged: (1) being like family; (2) advocacy as a key role; (3) challenges in communicating with other healthcare providers; (4) battling and striving to succeed against the odds. Although participants described involvement and commitment to quality palliative care, they also expressed a need for additional education and support about symptom control, language and access to specialist services and resources.
  
  
  CONCLUSIONS
  The residential aged care sector is in need of support for providing palliative care, yet there are significant professional and system barriers to care delivery. The provision of enhanced palliative care educational and networking opportunities for nurses and care assistants in residential aged care, augmented by a supportive organizational culture, would assist in the adoption of a palliative approach to service delivery and requires systematic investigation.
authors.affiliation: Mid-North Coast, NSW, Division of General Practice, School of Nursing, Family and Community Health, University of Western Sydney, Sydney, Australia. jphillips@mncdgp.org.uk
authors.forename: Jane
authors.initials: J
authors.lastname: Phillips
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Debra
authors.initials: D
authors.lastname: Jackson
authors.forename: Linda
authors.initials: L
authors.lastname: Kristjanson
authors.forename: John
authors.initials: J
authors.lastname: Daly
authors.forename: Jim
authors.initials: J
authors.lastname: Curran
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D001315:Australia; D017144:Focus Groups; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D009740:Nursing Staff; D010166:Palliative Care / Q000523:psychology*; D013727:Terminal Care / Q000523:psychology