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RESEARCH PAPER
https://doi.org/10.1071/PY22178
Allied health professionals’contribution to care at end of life in
aged care settings
Jennifer TiemanA,*, Deidre MorganB, Kelly JonesA, Sue GordonBand Amal ChakrabortyB,C
For full list of author affiliations and
declarations see end of paper
*Correspondence to:
Jennifer Tieman
Research Centre for Palliative Care, Death
and Dying, College of Nursing and Health
Sciences, Flinders University, Bedford Park,
SA 5042, Australia
Email: jennifer.tieman@flinders.edu.au
Received: 22 August 2022
Accepted: 8 January 2023
Published: 6 February 2023
Cite this:
Tieman J et al. (2023)
Australian Journal of Primary Health
doi:10.1071/PY22178
© 2023 The Author(s) (or their
employer(s)). Published by
CSIRO Publishing on behalf of
La Trobe University.
This is an open access article distributed
under the Creative Commons Attribution-
NonCommercial-NoDerivatives 4.0
International License (CC BY-NC-ND).
OPEN ACCESS
ABSTRACT
Background. The Australian population is aging, and the proportion of older Australians will
continue to grow over the coming decades. However, there is a lack of research published on
the specific roles and responsibilities of allied health professionals (AHPs) providing palliative
care within an aged care context. Understanding the roles and needs of AHPs providing care
during the last months of life in the community and aged care facilities could contribute to
workforce planning, targeted information and improved care. Methods. In total, 108 eSurveys
were collected between November 2019 to May 2020 from three allied health professions
working in government-funded aged care; the majority of these being in residential aged care.
Descriptive data are reported on the provision of care in key palliative care domains, care
settings and practice activity. Results. Nearly all respondents reported they had worked with
older Australians who had palliative care needs. However, over one-third of respondents
reported low levels of confidence in supporting clients or residents with palliative care needs.
The majority indicated they would benefitfrom additional education and training and support in
palliative care. Conclusions. This study investigated the role of the allied health workforce in
contributing to the care of older Australians at the end of life. It has also demonstrated that
there are gaps in practice activity and work role that must be addressed to ensure this
workforce can support older people with palliative care needs in receipt of aged care services.
Keywords: aged care, allied health, Australia, dietitians, end-of-life, home care, occupational
therapists, palliative care, physiotherapists, residential aged care.
Introduction
The Australian population is aging. In the 20 years to 2020, the proportion of the population
aged ≥65 years increased from 12.4% to 16.3% (Australian Bureau of Statistics (ABS)
2020). The growing number of older Australians has led to an increased demand for
aged care services, with many older people presenting with complex care needs or
entering residential aged care from hospital (Australian Institute of Health and Welfare
(AIHW) 2019; Aged Care Royal Commission 2021). This has contributed to a review of
current aged care policy issues in Australia and issues around care of older people at the
end of life (Aged Care Workforce Strategy Taskforce 2018; Aged Care Royal Commission
2021). The intersect of aged care, allied health and palliative care has been reflected in
the World Health Assembly 2014 statement, which recognises that palliative care should
be part of comprehensive care provision across the life course, and that provision of
generalist palliative care in non-acute settings is essential (World Health Organization
2014). Care for older people with palliative care needs is provided by a range of health
professionals in different settings, and allied health professionals (AHPs) play a key role
in this, with a particular contribution from occupational therapists, speech pathologists,
dietitians, psychologists, social workers, physiotherapists, and music therapists. AHPs
comprise the second largest health workforce in Australia, second only behind nurses.
They are central to the continuing care of older people and are a major contributor to
the care of older people in their homes, hospitals and in residential aged care facilities
J. Tieman et al.Australian Journal of Primary Health
(Howatson et al. 2015; Nielsen et al. 2017; Briggs et al.
2018; Brett et al. 2019; Aged Care Royal Commission 2021;
Allied Health Professions Australia 2021). Data have shown
that in 2020, there were 6661 permanent allied health
professionals and a further 5942 agency or subcontractor
allied health professionals working in residential aged care,
with 1807 in permanent positions and 1752 in agency or
subcontractor positions in home care, and 4022 in permanent
positions and 549 in agency or subcontractor working in
the Community Home Support Program (CHSP) (Australian
Institute of Health and Welfare (AIHW) 2022a). For resi-
dential aged care and home care, this equates to around 2%
of the workforce, and for CHSP around 4% (Australian
Institute of Health and Welfare (AIHW) 2022a). Allied health
engagement with aged care is influenced by the complexity
of funding arrangements, availability of staff in rural and
remote areas, referral processes, experiences in aged care
settings in allied health training, and differences in work
settings (Allied Health Professions Australia 2020; Couch
et al. 2021). A lack of workforce data relating to allied health
has also hampered both understanding of, and planning for,
allied health contribution in aged care services (Department
of Health 2022).
As more older Australians approach the end of life, it is
likely that increasing numbers of Australians and their care
providers will need to draw on the skills and services
offered by AHPs (Royal Commission into Aged Care Quality
and Safety 2021a). In 2020, 161 300 deaths were registered
in Australia, with the majority of these occurring among
older people. Sixty-six per cent of these deaths were among
people aged ≥75 years, with a median age at death of
79 years for males and 85 years for females (Australian
Institute of Health and Welfare (AIHW) 2022b). Aged care
is often involved in supporting people in the last years
of life. A recent analysis showed that 67% of people aged
≥50 years had used at least one aged care program in the
2 years prior to death, and that this increased to 86% for
those who died aged ≥85 years (Australian Institute of
Health and Welfare (AIHW) 2021).
Palliative care addresses the physical and psychosocial
needs of people who have a life-limiting illness, and aims
to enable them to live well until their death regardless of
their background, where they live or the setting of their
care. The National Palliative Care Strategy recognises that
people die in a range of care settings, including in the home,
hospitals, residential aged care facilities and hospices,
and that medical, nursing and AHPs will be involved in
palliative care provision (Department of Health 2018). An
emerging body of literature demonstrates the role of AHPs
in specialist palliative care in optimising function, non-
pharmacological symptom management, and supporting
psychological and spiritual adjustment to deterioration and
approaching death (Chahda et al.2017; Eva and Morgan
2018; Morgan et al.2019a; Gravier and Erny-Albrecht 2020).
However, there is limited research on how AHPs support care
in the last months of life in aged care.
In Australia, the aged care system is overseen by the
Australian Government, which also funds the majority of
aged care services, including subsidised home care packages
and residential care (Department of Health 2020). As more
older Australians, and older Australians approaching end of
life utilise these services, there has been increased demand
for AHPs. Data from the 2018 ABS survey of those in aged
care show that half of people aged >65 years with a
disability (Australian Bureau of Statistics (ABS) 2018)may
benefit from restorative or reablement approaches (Lewis
et al.2021). Most people in residential care had high care
need ratings in at least one care domain, most commonly for
activities of daily living, cognition and behaviour or complex
health care (Australian Institute of Health and Welfare
(AIHW) 2021). Residents may therefore require assistive
equipment and specialist supports to maintain and optimise
function (Australian Bureau of Statistics (ABS) 2018), which
is core business for AHPs (Blackler et al.2018; Matlick et al.
2019). However, the 2020 Aged Care Workforce Census and
Survey showed that AHPs equate to only 2% of the residential
aged care workforce (Department of Health 2021). Despite
anticipated need for allied health services, there is lack of
research on the specific roles and responsibilities of AHPs
providing palliative or end-of-life care within an aged care
context.
End of Life Directions for Aged Care (ELDAC) is a project
funded by the Australian Government Department of Health
and Aged Care to support quality care for older Australians
at the end of life (ELDAC Project 2021). ELDAC aims to
connect people working in aged care with palliative care and
advance care planning information, resources and services.
Understanding the roles and needs of the allied health
workforce providing care at the end of life to older
Australians in receipt of aged care services could contribute
to workforce planning and enable more targeted education
and information resources that improve care.
The aims of this study were to:
1. Identify the roles and responsibilities of AHPs working
with older Australians with palliative care needs in
Australian Government-funded residential care and
home care.
2. Explore AHPs’ knowledge and understanding about
palliative and end-of-life care.
3. Ascertain AHPs’ palliative care educational, clinical and
knowledge needs.
Methods
This cross-sectional study utilised electronically collected open
survey (eSurvey) data from seven allied health professions:
occupational therapy, speech pathology, dietetics, social
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work, psychology, physiotherapy, and music therapy. Eligible
AHPs completed an eSurvey between November 2019 and May
2020. This paper reports on the findings of three of these
allied health professional groups, representing those with the
highest proportion of responses to the eSurvey – occupational
therapists, physiotherapists and dietitians. The eSurvey was
designed to capture key allied health workforce characteristics
as they relate to the delivery of palliative care in the residential
or home care, aged care setting. Global questions on palliative
care and advanced care planning, as well as demographic
and workplace characteristics, are reported (See Online
supplement 1: online survey)
Questions were developed, trialled and peer reviewed
prior to distribution through ELDAC channels and allied
health professional groups. The online survey data collection
was managed through the CareSearch Research Data
Management System (Tieman 2016).
Data items
The survey comprised questions about: socio-demographic
characteristics of AHPs; types of aged care services; popula-
tion setting in which care is provided; specific clinical roles;
advance care planning; and skills, training, knowledge and
perceptions on palliative care. The eight-domain ELDAC
care model was used as a framework for examining allied
health activities and designing the survey (Tieman 2019).
Data collection
The eSurvey was designed to take 10–20 min to complete
and no participants were individually identifiable in the
data. Quantitative and qualitative data were captured, with
the majority of questions closed-ended. Single or multiple
answer options were provided depending on question type.
Ethics
Approval to conduct this study was obtained from the
Human Research Ethics Committee of Flinders University
(Ref # 8508).
Survey distribution
The professional bodies of occupational therapists, dietitians
and physiotherapists were asked to distribute the eSurvey
to their members via their communication channels and
networks. The eSurvey was distributed over a 6-month
period via electronic newsletters, websites and social media
platforms including LinkedIn, Facebook and Twitter more
than once, with a potential reach of 70 000 allied health
professionals. A PDF version of the Participant Information
Sheet and a direct link to the online survey were distributed
to participants electronically. Participation and submission of
the survey online implied informed consent.
Data analysis
Data extracted from the Research Data Management System
(RDMS) platform were analysed using SPSS software, ver.
25.0 (SPSS Inc.). Descriptive statistics were used to analyse
data. The qualitative data collected will be analysed and
reported on separately.
Results
Demographic, professional and workplace
characteristics
Table 1 shows the demographic, professional and workplace
characteristics of all occupational therapy, dietetic, and
physiotherapy respondents. Respondents were predominantly
female (83.3%) and the majority were aged >41 years (51%).
In total, 54.6% held a bachelor’s degree only, and a large
proportion of respondents had completed a postgraduate
higher degree comprising a Master’s and/or a Doctoral degree
(40.8%). And 97.2% of respondents identified as non-
Indigenous. Approximately half (52.8%) of the respondents
had >10 years of experience practising as an allied health
professional.
Scope of allied health practice in palliative care
in aged care
Table 2 shows the scope of allied health practice in palliative
care, in aged care. Although 108 respondents representing
occupational therapy, dietetic, and physiotherapy groups
participated in the survey, not everyone answered each
question relevant to their scope of practice. Most respon-
dents worked as a part of a multidisciplinary team (85.7%)
alongside nurses, medical doctors and pharmacists. Of these,
59.0% received referrals to work with older Australians from
residential aged care facilities and aged care service
providers. There was widespread recognition of palliative
care, as defined by the World Health Organization, with
97% acknowledging they cared for older Australians with
palliative care needs or life-limiting illnesses. Almost two-
thirds (60.9%) perceived that between 25 and 75% of older
Australians whom they currently cared for could die in the
next 12 months.
Respondents were asked how confident they were in
recognising, providing, and defining their role at work for
older Australians with palliative care needs. Almost two-
thirds of respondents self-reported that they were completely
or fairly confident in recognising (60.2%), providing care for
people with palliative or end-of-life care needs (65.5%)
and defining their role in working with older Australians
with palliative care needs (65.3%). All (100%) of the
respondents reported that they worked with older persons
with dementia, and the majority worked with financially
C
J. Tieman et al.Australian Journal of Primary Health
Table 1. Demographic, professional and workplace characteristics of
respondents (N= 108).
n%
Gender
Female 90 83.3
Male 18 16.7
Age (years)
20–30 30 27.8
31–40 23 21.3
41–50 26 24.1
51–64 27 25.0
65+ 2 1.9
Highest academic qualification
Diploma 5 4.6
Bachelor 59 54.6
Masters 42 38.9
Doctorate 2 1.9
Identify as being of Aboriginal and/or Torres Strait Islander descent
Yes (Aboriginal/Torres Strait Islander) 3 2.8
No (Non-Indigenous) 105 97.2
Years practising as an allied health practitioner
<1 6 5.6
1–5 32 29.6
6–10 13 12.0
>10 57 52.8
Current occupation
Dietitian 39 36.1
Occupational therapist 37 34.3
Physiotherapist 32 29.6
Work setting
Home care 27 25.0
Residential care 53 49.1
Both home care and residential care 28 25.9
and socially disadvantaged (96.6%), and culturally and
linguistically diverse (95.5%) priority population groups.
Just over one-quarter of all respondents (26.4%) worked
with care leavers (i.e. people who lived in institutions as
children, forgotten Australians and former child migrants).
Nearly half were satisfied or very satisfied with their
workplace support; however, one-third (31.3%) remained
‘neutral’, indicating neither satisfied or very satisfied, with
a remaining 19.3% unsatisfied or very unsatisfied with
workplace support. The majority of respondents (95.3%)
held the view that profession-specific clinical practice should
be developed to better support their work practice in
palliative care. Factors limiting adequate care provision for
older Australians with palliative or end-of-life care needs
included time constraints (37.8%), ‘insufficient funding’
(28.0%) and limited understanding of the scope of AHPs'
role (25.2%).
Relevance of ELDAC Care Model domains to
clinical practice
Table 3 lists the eight domains of end-of-life care for older
Australians with palliative care needs and their relevance to
allied health clinical practice. The top three domains were:
‘Working together as a team to meet the specific needs of
the individual’ (94%); ‘Responding to deterioration so that
changing needs are identified and care plans are updated to
meet new care needs’ (88.0%); and ‘Providing palliative care
including delivering care, reassessing needs and monitoring
for changes’ (76.2%). Managing dying (26.5%) and bereave-
ment (34.9%) scored the lowest level of involvement.
Discussion
This study investigates the contribution that dietitians,
occupational therapists, and physiotherapists play in the
care of older Australians with palliative care needs in
residential aged care and in-home care settings. AHPs were
aware that residents and clients could be in the last months
of life and were able to articulate the need for palliative
care in this population. Although AHPs are often grouped,
each discipline can contribute profession-specific skills
and knowledge to meet the individual needs of clients and
residents. Several issues arising from this study that have
implications for care of older people at the end of life
warrant further discussion.
The majority of AHPs completing the survey reported that
they worked in multidisciplinary teams, which is consistent
with the ELDAC Care Model and seen as critical in the
National Palliative Care Standards (Palliative Care Australia
2018). However, what is not clear from these findings is
which disciplines comprise the multidisciplinary team, and
the extent and nature of AHP engagement in the multidisci-
plinary team. There are general aspects of palliative care
knowledge and practice needed by all health professionals,
such as communication skills and recognising deterioration,
but AHPs would not be expected to provide all aspects
of palliative care delivery alone. The specific contributions of
different AHPs in meeting the individual care needs of older
people identified as palliative and/or coming to the end of
their life should also be more broadly acknowledged within
the multidisciplinary team context.
Also, although there appeared to be good recognition of
the definition and purpose of palliative care, this did not
necessarily reflect confidence in their clinical practice, with
around one-third of AHPs reporting they do not feel confident
in defining their work role as it related to palliative care
(30%). This accords with earlier work that showed that
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Table 2. Scope of allied health practice to care for older Australians with palliative care needs.
n%
From where do you get referrals to work with older Australians in aged care services? (Tick all that apply) (n= 99)A
Referral from an aged care services provider 51 25.5
From a residential aged care facility 67 33.5
From a general practitioner or other healthcare professional 50 25.0
From the palliative care team 28 14.0
I don’t get referrals to work with older Australians in aged care services 4 2.0
In your current role, do you care for older Australians with palliative care needs or who are facing life-limiting illness? (n= 88)
Yes 85 96.6
No/Unsure 3 3.4
Have you ever cared for older Australians with palliative care needs or who are facing life-limiting illness? (n= 88)
Yes 86 97.7
No/unsure 2 2.3
In your opinion, what percentage of older Australians whom you currently care for could die in the next 12 months? (n= 87)
<25 31 35.6
25–50 34 39.1
50–75 19 21.8
>75 3 3.4
Do you work in a multi-disciplinary team? (n= 84)
Yes 72 85.7
No 12 14.3
How confident are you at recognising palliative care needs in older Australians? (n= 88)
Completely confident/fairly confident 53 60.2
Somewhat confident/not very confident/not at all confident 35 39.7
How confident are you in providing care to older Australians with palliative care needs? (n= 87)
Completely confident/fairly confident 57 65.5
Somewhat confident/not very confident/not at all confident 30 34.4
How confident are you at defining your role at work when caring for older Australians with palliative care needs? (n= 84)
Completely confident/Fairly confident 54 64.3
Somewhat confident/Not very confident/Not at all confident 30 35.7
How satisfied are you with workplace support in caring for those with palliative care needs? (n= 83)
Very satisfied/Satisfied 41 49.4
Neutral 26 31.3
Unsatisfied/Very unsatisfied 16 19.3
Do clinical practice guidelines need to be developed to better support your work practice in palliative care? (n= 106)
Yes 101 95.3
No 5 4.7
Current perceived workplace limitations (tick all that apply) (n= 77)B
Workplace policy 13 9.1
Insufficient funding 40 28.0
Time constraints 54 37.8
A limited understanding of the scope of your role working with older Australians with palliative care needs 36 25.2
ANumber of AH respondents = 99. Multiple responses for this question resulted in a total of 200 responses (i.e. result contains ‘yes’responses only).
BNumber of AH respondents = 77. Multiple responses for this question resulted in a total of 143 responses (i.e. result contains ‘yes’responses only).
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J. Tieman et al.Australian Journal of Primary Health
Table 3. In your current role caring for older Australians with
palliative care needs, have you been involved in the following eight
domains of end-of-life care?
Eight domains of the ELDAC Care Model Yes No Total
n n N
% % %
Advance care planning, to be aware of the wishes 46 38 84
and preferences of the individual 54.8 45.2 100.0
Recognising end of life by proactively considering 45 38 83
whether the person could have changes indicating 54.2 45.8 100.0
that death is foreseeable
Assessing palliative care needs, to enable 46 36 82
comprehensive identification and planning of care 56.1 43.9 100.0
Providing palliative care including delivering care, 64 20 84
reassessing needs and monitoring for changes 76.2 23.8 100.0
Working together as a team to meet the specific 79 5 84
needs of the individual 94.0 6.0 100.0
Responding to deterioration so that changing needs 73 10 83
are identified, and care plans updated to meet new 88.0 12.0 100.0
care needs
Managing dying with an appropriate plan for the last 22 61 83
days of a patient’s life 26.5 73.5 100.0
Bereavement so that family, friends, residents and 29 54 83
staff are supported with grief and loss 34.9 65.1 100.0
AHPs felt undergraduate education left them underprepared
to work with people at the end of life (Morgan et al. 2019a).
The need for an appropriate skill set and qualifications for
all disciplines, including allied health, is recommended
in the National Palliative Care Standards (Palliative Care
Australia 2018).
More than half of the respondents in this study reported
timing and funding constraints as a major factor limiting
their ability to provide appropriate care. Further, 25% of
participants reported that the scope of their role when
working with people who had palliative care needs was
poorly understood. The ‘Matter of Care’ Aged Care Workforce
Strategy states there is a risk of scope creep for nursing in aged
care and its role in contributing to their burn out by expecting
nurses to take on jobs outside their scope of practice,
rendering them unable to fully utilise their technical skills
(Aged Care Workforce Strategy Taskforce 2018). However,
the same document proposes that nurses extend their scope
of practice to address residents’ functional and cognitive
needs (p. 25). Increased utilisation of AHPs’ skilled expertise
in optimising physical and cognitive function would not only
improve older Australians’ quality of life, but reduce pressure
on nursing staff to take on jobs outside their scope of practice.
Although approved changes to Australian legislation will
require a registered nurse onsite and on duty 24 h a day,
7 days a week, which could support care for residents with
palliative care needs and those coming to the end of their
life, there is still a limited uptake of AHPs in RACFs and
this warrants review for the reasons discussed below.
Allied health professionals’ expertise lies in their skilled
assessments and interventions to optimise physical and
cognitive function for older people approaching the end of
their life while minimising risk (Chahda et al. 2017; Nielsen
et al. 2017; Blackler et al. 2018; Brett et al. 2019; Matlick
et al. 2019; Sterke et al. 2021). A multidisciplinary approach
with strong AHP representation is already employed in
rehabilitation wards across Australia’s hospitals and in the
community. Multidisciplinary rehabilitation contributes to
optimising physical and cognitive function and offers practical
support and education of formal and informal carers. A reha-
bilitative approach has been endorsed by a 2021 World
Health Organization (WHO) report on health services and
palliative care (World Health Organization (WHO) 2021)as
an integral part of care for those with palliative care and
end-of-life needs, as it can optimise function, and reduce
unwanted hospital admissions and health complications.
A rehabilitative approach for end-of-life care in an aged
care context could support nursing and personal care staff,
and family carers while optimising older adults’ safety,
independence and quality of living at the end of life.
An Australian study of trajectories of functional decline
at the end of life found that people, especially those with
dementia, experience sustained periods of dependency on
others (Morgan et al. 2019b). The Royal Commission into
Aged Care Quality and Safety (2021b) was clear in its
message about the potential contribution of allied health
and the maintenance of quality of life and function as far
as possible, including through to the end of life. As the
Commission Report notes: ‘Older people and their carers
should be supported to balance their care needs. If older
people wish to undertake social and community-based
activities, or access equipment and technology to make life
easier, they should be able to do so. They should have
access to a wide range of allied health services to maintain
or improve their capacities and prevent deterioration as far
as practicable.’ (p. 36). Assessment for, and prescription of,
assistive equipment to optimise function in aged care is
core business for AHPs (Nielsen et al. 2017; Blackler et al.
2018; Matlick et al. 2019; Sterke et al. 2021).
Earlier research has identified the need for free, accessible,
relevant educational and professional development resources
to support allied health clinical practice with people who have
palliative or end-of-life care needs (Morgan et al. 2019a).
Given 95% of respondents in this study indicated a need for
allied health-specific clinical practice guidelines, mapping
existing guidance within the allied health, aged care and
palliative care peak bodies should be undertaken. Moreover,
given most respondents report working with clients and
residents from very diverse cultures and backgrounds,
resources relating to the aged care diversity framework
could facilitate widespread AHP support for person-centred
care at the end of life. Both person-centred care, which
looks at the whole person, not just their health problem,
and consumer-directed care, which sees the older person as
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in control of decisions about their care, recognise the
importance of the older person in care decisions and practices
(Håkansson Eklund et al. 2019).
Finally, with around one-third of participants working
in both residential aged care and with clients on a home
care package, these AHPs can face challenges in navigating
multiple reporting and funding systems, adding to the
complexity of their professional practice. Information and
clarity about communication practices, pathways of care and
integrated care processes may be of value. Digital solutions
with respect to practice management and reporting to those
commissioning allied health services may also be valued.
ELDAC has a potential role to play nationally by
signposting to and/or developing articulated resources
and guidance to support AHPs working within the aged care
sector. This would complement existing palliative care
training and knowledge resources, such as the Program of
Experience in the Palliative Approach (PEPA) or CareSearch’s
Allied Health Hub funded through the Australian Government’s
National Palliative Care Program.
Conclusion
Allied health practitioners are a heterogeneous group of
providers with specialised and unique skills, which facilitate
a consumer-directed approach to care, as promoted through
the aged care quality standards and is consistent with
palliative care principles. This study investigated the role of
the allied health workforce in contributing to the care of
older Australians at the end of life. It has also demonstrated
that there are gaps in practice activity and work role that
must be addressed to ensure this workforce can support
older people with palliative care needs in receipt of aged
care services.
Limitations
This paper reports on findings from a self-selected group of
allied health professionals and may therefore not represent
the views of all allied health professionals working in aged
care who may be providing support to an older person
coming to the end of their life or with palliative care needs.
Analysis of data may not capture differences between home-
based aged care and residential care. Despite a considered
approach to promotion and distribution and contact with the
allied health professional bodies, the number of respondents
was low. Again, this may affect the generalisability of the
data. Data on three allied health professional groups only
was included in this paper as the number of respondents for
other professional groups, such as social workers or music
therapists, were too low to be meaningfully analysed.
Supplementary material
Supplementary material is available online.
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Data availability. The data that support this study will be shared upon reasonable request to the corresponding author.
Conflicts of interest. The authors declare no conflicts of interest.
Declaration of funding. This study was supported by the Australian Government Department of Health and Aged Care-funded End of Life Directions for Aged
Care (ELDAC) Project, grant no. H1617GO5057. The views expressed in this article do not necessarily reflect the views of the Australian Government.
Acknowledgements. The authors would like to thank the allied health professionals who contributed to the survey responses. The authors would also like to
acknowledge the contribution of Rosa Katsikeros, Caroline Litster and Seth Nicholls, for their support with the survey, data analysis and report writing.
Author affiliations
AResearch Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia.
BCollege of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia.
CUniversity of Sydney, Sydney, NSW, Australia.
H
