Your Mind Does Matter

The purpose of this grant round was to develop a “Social Work Palliative Care Case Management” approach for the delivery of a “PallCare Packaged” model of care, and to pilot the integration of mental illness into ‘palliative care’ care planning and case management interventions for people with life limiting or terminal illnesses across selected rural communities.

This report highlights the objectives, strategies and outcomes of this very successful grant round.

The Amaranth “Outside the Silo” project aimed to assist in improving the health and wellbeing of rural farming families through the following interventions:

  • Developing partnerships and collaborative working relationships with rural support and mental health workers to address the financial, social, emotional, psychological and existential needs of farming families across the Riverina.
  • Use the working relationships with other mental health workers to buy leverage in rural communities where Amaranth does not have a presence, to and break down stigma and unease by farming families in accessing health information.
  • Provided education in regard to advance care planning, living with advanced diseases, carer strain, existential needs, with rural support and mental health workers to enable increased capacity and sustainability of mental health services across all rural communities
  • Developed a Community of Interest (CoI) consisting of Amaranth social workers, rural mental health workers, rural support workers and any other related rural health and community based services in the Leeton Shire to identify gaps in service delivery, provide shared problem solving and information sharing in a therapeutic and supportive environment.
  • Increased access to information and resources for local and regional farmers and farming families by having a visible and active presence at the regional agricultural Field Days.

A Project funded under The Care Planning Sub-Program Of the Local Palliative Care Grants Program

Australian Government Department of Health and Ageing: 2006-2009

This report outlines key recommendations for policy and funding based on the key themes and outcomes of this action research project.

Key Messages for Decision Makers

A model of care planning suitable for people requiring palliative care in rural and remote communities needs to be flexible, multidimensional, multidisciplinary, incorporate both the biological and psychological care aspects, be sensitive to the specific needs and population trends of each community, be sustainable, be equitable and available to all people living with an eventually fatal (terminal) condition.

This action research project – Rural and Remote Palliative Care Planning Model, has enabled us to trial and developed a new model of care that will address many of the identified gaps and challenges in providing palliative care, reduce the inequalities in service provision in many rural and remote communities, is affordable and accessible and ensures that Palliative Care is provided within the framework and standards as set out by Palliative Care Australia and is available to all Australians in rural communities that need it.

A comprehensive literature review was conducted to provide the evidence base to underpin this new model. This model was trialled in 32 rural communities, reaching 350 clients, and provided a range of services such as specialist social work case management; common intake, assessment and consent processes that incorporate the patient, the family and care giver/s as the unit of care and provided a flexible brokerage of equipment and services.  A rigorous evaluation of the trial indicated that the model provided significant benefits for patients, their family members, care giver/s, service providers and the broader health system.

This new model of care – PallCare Packages – operates similarly to the ComPacks model in generalist community care services. Key elements of this new model include:

  • Specialist social work case management
  • Common intake, assessment and consent processes that incorporates the unit ofv care being the patient, the family and care giver/s
  • Flexible brokerage of equipment and services
  • Development of partnerships between key service providers and stakeholders in each community
  • Multidisciplinary care planning
  • Continuity of care and seamless referral processes
  • Psychosocial support for the patient, carer and family, including grief and loss / bereavement information and support
  • Home Notes
  • Carer support and information, , available 24 hours, seven days a week,
  • Professional support, education and supervision

In 2012, Amaranth Foundation submitted a report into the Senate Inquiry into Palliative Care in Australia.

The Inquiry:

On 23 November 2011, the Senate resolved to refer the matter of the provision of palliative care in Australia to the Senate Community Affairs References Committee for inquiry and report by 12 September 2012. The Senate subsequently extended the time for reporting to 19 September 2012 and then again to 10 October 2012

In referring the matter for inquiry, the Senate agreed to the following terms of reference:

The provision of palliative care in Australia, including:

The factors influencing access to and choice of appropriate palliative care that meets the needs of the population, funding arrangements; efficiency, effectiveness and appropriateness of current service delivery; the adequacy of the palliative care standards, advanced care planning and the availability and funding for research.