Project summary
Southern Cross Care WA in partnership with Edith Cowan University has been awarded an ARIIA grant for their project ‘Creating an evidence base for the timely introduction of the 'No One Dies Alone' program in Residential Aged Care’.
The idea of dying alone is not in keeping with the notion of a ‘good death’. For most people having a human connection near the end of life is important.
The No-One-Dies-Alone (NODA) program has been introduced in many health settings, demonstrating success anecdotally. The purpose of this project is: firstly, to create an evidence base for No-One -Dies-Alone and secondly, to solve the problem of its timely initiation in Residential Aged Care.
The program aims to ensure that residents in the active dying phase, 24-48 hours prior to death, will have companionship, be it a family member, a friend, or a volunteer. Recognition of the end-of-life transition to active dying, to enable timely and effective intervention, is challenging. The Southern Cross Care No-One-Dies-Alone program will incorporate an innovative evidence-based guideline for recognising the dying process and assist the Registered Nurse/Nurse Manager in determining the best time to initiate companionship.
Based upon a completed needs assessment, the education, training, and the process required will be developed and incorporated into the program that will be implemented at Southern Cross Care WA (SCC). Evaluation will provide the evidence base for the timely and effective implementation of NODA for the future.
Project outcomes
Background and Aims
The project was based on the notion that for a ‘good death’ to take place, most people would want human connection near end-of-life. The project planned to place trained volunteers at the bedside of dying residents in Residential Aged Care within Southern Cross Care WA at two pilot locations. These volunteers were recruited, trained and mobilised. To better predict when the final stage of life was approaching so that volunteers could be called in, a more accurate understanding of the dying process was required. Here a Guide to Recognising Active Dying (GRAD) was developed by our research partners and tested by the clinical staff within the RAC homes of Southern Cross Care WA. The effectiveness of the NODA programme was evaluated by our research partners for future quality improvement.
What we did
We adapted the NODA programme that was started in the USA in 2001. After extensive planning and preparation, we recruited volunteers, trained them and readied them for service. While this was happening, our research partners were preparing the GRAD Chart and training our clinical staff. Once the programme was launched in April 2024, volunteers were deployed and data was collected for the necessary evaluation.
Outcomes
The GRAD Chart was easy for clinical staff and carers to use and this facilitated a timelier call-out of volunteers to the bedside. People associated with aged care (staff, family and friends) came to see that there was value in having human contact at the end of life.
Impact on Aged Care and Workforce
The programme has heightened the attention on palliative care and in particular on the need for human presence, not simply medical interventions, when life is concluding.
Resources Developed
- Training manuals, and training videos, can be accessed by contacting the NODA Project Lead at NODA@scrosswa.org.au.
- The use of the GRAD Chart can be accessed by contacting Prof. Davina Porock at the Centre for Aged Care Research at Edith Cowan University.
- Journals articles, conference presentations and other media due to appear can be accessed through the above Centre at Edith Cowan University.
Next Steps
- The programme is scheduled to be rolled out across all our residential aged-care homes.
- We plan to make information on the project available to aged-care providers in Australia.