1273 Advance care planning insights from residential aged care services implementing PACOP

<h3>Background</h3> The proportion of the population who could benefit from advanced care planning is increasing due to disease and age-related trends. Between 2022–2023 there were 62,062 deaths of people living in residential aged care facilities (RACFs). The AIHW National Palliative Care report outlines measures of appropriate palliative care related to an individual’s preferred location for end-of-life care (EOL), and proportion of Australians with advance care plans. The Strengthened Aged Care Standards introduce palliative and EOL clinical standards, including the requirement to support EOL planning conversations, discuss care and review advance care planning documents to align with current needs, goals and preferences. The Palliative Aged Care Outcomes Program (PACOP) provides a national approach to standardise early recognition of the need for palliative and EOL care and identifies opportunities for advance care planning in RACFs. Information on advanced care planning practices, and knowledge of those who would benefit from advance care planning in this setting is lacking. <h3>Aim</h3> To identify clinical and demographic characteristics of persons living in RACFs associated with documentation of EOL preferences, advance care plans/directives in place, nomination of alternate decision makers; and to describe the actions to review or develop an advance care plan—as identified by the RACF workforce. <h3>Method</h3> Routinely collected assessment data from RACFs participating in PACOP are reported bi-annually. Demographic and clinical characteristics, advance care planning and alternate decision making, identification of the need for palliative care and actions based on assessment between July to December 2024 were analysed. <h3>Results</h3> There were 8649 assessments completed on 5712 residents— 64% were female, with an average age of 85.2 years, 9% preferring a language other than English. 79% had their EOL needs, wants and preferences documented while 86% had an advance care plan/directive documented. 90% had an alternate decision maker nominated. 65.3% of residents communicated a moderate amount or better. 7.5% of assessments identified that an advance care plan required development or review. Palliative care needs were recognised in 14% of assessments. Of the 1051 deaths reported to PACOP, 51% died with an advanced care plan/directive in place. <h3>Conclusion</h3> Whilst the majority of residents in RACFs have advanced care plan/directives completed and alternate decision makers nominated, there is variability in advance care planning for residents who died. Greater participation in PACOP nationally, and submission of the complete PACOP dataset, will support identification of opportunities in RACFs for continuous quality improvement related to advance care planning practices.