Shifting the aged care culture from caring “for” residents to caring “about” residents: Advocating for a compassionate communities approach to care

Background: An independent evaluation sought to understand the broader impacts of the West Australian National Partnership Agreement for Comprehensive Palliative Care in Aged Care projects on residents and their families. Objective: This study aimed to gain a bereaved carer perspective on palliative care in Western Australian residential aged care homes (RACHs), identify challenges/gaps in care provision, and consider how service delivery can be improved to meet community needs and expectations. Design: An online survey of bereaved family carers of people who died in RACHs from 2021 to 2024. Methods: The questionnaire was structured according to the six strategic priorities outlined in Western Australia’s End-of-Life and Palliative Care Strategy (2018–2028). Descriptive analyses were conducted. Results: Three hundred and seventeen bereaved carers across 46 RACHs responded. 40.6% of carers reported their relative accessed visiting palliative care services during their residential aged care stay, 30.6% did not access, and 28.8% did not know. Overall, bereaved carers whose relatives accessed palliative care reported better experiences for residents and themselves compared with those who did not. However, the respondents called for a more person-centred care system encompassing residents’ needs, more timely information, better communication, and appropriate resources to feel supported before and after bereavement. They also wanted to be more involved in care decisions undertaken within RACH. These needs were reflected in priorities 2 (care is person-centred) and 4 (families and carers are supported), which were rated the lowest among the six priorities. Conclusion: This study makes three contributions to ageing policy discourse. First, it provides empirical evidence that despite policy directives towards person-centred care, residential aged care continues operating through institutional “caring for” rather than relational “caring about” frameworks. Second, it reveals implementation gaps in palliative care policies, particularly in bereavement support and family involvement in care decisions. Third, it proposes a compassionate communities approach to care as a social practice and policy framework addressing both quality concerns and sustainability challenges.