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Unintended and Unnecessary Transfers

Unintended or unnecessary transfers should be minimised to provide better care and reduce distress for people in the palliative phase.

  • The person is transferred unnecessarily when they could have been cared for in their current setting.
  • The person receives unwanted care or treatment that causes discomfort, distress, or provides no real benefit.
  • The person dies in a place they did not want to be, receiving care they did not wish for, because of being transferred.
  • Family and friends may not be present when the person dies due to the transfer.
  • Worry about dosing: Worrying about giving the wrong dose can lead to hesitation and stress.
  • Support staff confidence: Educate and empower staff to feel confident in providing end-of-life care and understanding how to respond when transfers are proposed.
  • Discuss and document preferences: Talk openly with the person about their preferred place to die and ensure this is clearly recorded in their care plan.
  • Review care plans: Check that the person’s preferred place of death and any Advance Care Directives are documented, and ensure staff are aware of these preferences.
  • Track transfer decisions: Regularly review transfers to understand when and why they happen. Use this information to identify patterns and improve decision-making in the future.

Planned transfers happen when a person chooses to move between care settings, such as:

  • a hospice or specialist palliative care
  • an aged care home
  • their own home or a family member’s home
  • a hospital.

Transfers to and from hospitals may also occur when aged care cannot provide required medical treatment, such as for pain management, or in emergency situations such as after a fall.

Unnecessary transfers should be avoided to reduce risks, prevent distress, and support the person to receive care or pass away in their preferred place.

Whenever a transfer occurs, whether to or from an acute care setting, suitable documentation should be provided to support ongoing care.