Wellbeing worry: Palliative care workforce faces rising demand

Insights from Palliative Care Australia reveal increasing demand for the palliative care workforce with roughly half experiencing signs of burnout while satisfaction rates for self-care plus physical and financial health are worryingly low.

“The palliative care, aged care, and broader health sectors in Australia are under unprecedented pressure. With an aging population and increasing complexity of care needs, workers in these fields face challenges that significantly impact their wellbeing,” the report stated.

Key points

• Wellbeing in palliative care workforces features data from 1,400 survey respondents with 53% working in specialist palliative care and 18% in aged care, while other respondents include primary and health care workers and volunteers
• One in four had more than 20 years’ experience in palliative care, 30% had 10-19 years’ experience and just over 40% had been in palliative care for less than 10 years
• Roughly 80% of respondents reported increased demand for palliative care in the last year, however, less than half said funding has failed to keep up with the demand
• Many workers would like more structured support for self-care and mental health, and the vast majority also supported better training and education opportunities

Ageing workforce

Demand for palliative care services has increased due to the rise in chronic and life-limiting conditions: 61% of all Australians have at least one chronic condition, rising to 94% of people aged 85 and over.

As highlighted by Palliative Care Australia (PCA), 80% of workers have seen increased demand for palliative care services in the past year. But with only 39% believing that their services were appropriately funded there is a major disconnect between demand and resources. 

This in turn leads to additional stress and burnout in a workforce that is also ageing, resulting in potential experience loss. PCA said there is a generational gap across Australia, especially in rural and remote areas, and staff are concerned about who takes over in this specialised field.

“The ageing skilled workforce is withdrawing or retiring, and a new, often younger workforce has started to be recruited, who don’t have the skills and knowledge,” one respondent said.

Burnout and self-care

Burnout is common across the entire aged care sector with COVID-19 a particularly damaging experience for most. Its effects continue to linger, although PCA found that half of respondents have seen their wellbeing improve since the height of the pandemic.

“The appalling way the aged care sector was treated by the government in isolating older people and keeping them from their loved ones for so long… It was the worst experience of my entire career,” a respondent said.

Unfortunately, 14% feel that their wellbeing has worsened. PCA said, “This suggests that while the pandemic had a significant impact, most workers have been able to recover or maintain their wellbeing in its aftermath, however, the 14% who report a worse wellbeing score should not be ignored.”

With 44% of specialist palliative care workers and 41% of aged care workers reported experiencing signs of burnout “quite often” or “very often”, continued efforts by aged care employers are also essential to ensure staff do not feel neglected. 

Some employers do offer additional support outside of the employee assistance program (EAP) with respondents highlighting opportunities for debriefing and access to mental health services. Most do rely on self-care and peer support, though, with calls for more formal resources. 

New challenges 

Employers will have to recognise the evolving landscape of palliative and end-of-life care, with expanded access to Voluntary Assisted Dying (VAD) one of the new challenges highlighted by PCA.

Although 82% of palliative care workers are comfortable with VAD and directing people to VAD information, some workers struggle with the ethical and emotional implications. PCA called for additional training and support. 

“There is a natural emotional load that comes with this work; the intensity of the relationships built with patients and their families can be incredibly rewarding and are important – therefore the need for ongoing formal and informal support for staff who work in this space is critical,” Camilla Rowland, Chief Executive Officer, PCA said.

The desire to learn more is common across this highly talented cohort with 85% of respondents interested in receiving training on topics related to palliative care. With roughly one-third of respondents revealing they do not feel like they are satisfied in terms of their ability to do a good job, this training will be critical for elevating all workers to a position of confidence.

So too will be the provision of structured support for self-care and mental health. PCA stated there is a clear need for more formalised systems of debriefing and supervision.

PCA’s full report on wellbeing in palliative care workforce can be viewed here.