This paper examines progress to date of a Community of Practice (CoP) as a strategy to enhance a palliative approach and care continuity for people who have dementia. While a palliative approach is appropriate on a needs basis throughout the trajectory of a life limiting illness, this study focuses on such an approach for persons with dementia and for whom death within the next 6 months would not be surprising. Additionally, care continuity is recognised as a fundamental aspect of best practice, facilitated by common understandings of best practice, the care needs of clients and their families, and policies/protocols that support such understandings. Acting as a catalyst for change, a collaborative and inter-sectoral CoP may be ideally placed to identify shared goals and how these might be met.

This study, funded by the Australian Government Department of Health and Ageing, employs an Action Research approach and collaboration across two States – Tasmania and WA. Ten CoP members were recruited in each State from staff in 4 participating community and residential aged care facilities, 2 acute care settings, 2 in-home respite care providers, 2 local GP divisions, and 2 GP practices. The two CoPs met regularly in 2010, drawing on the baseline evaluation from surveys/interviews with family carers/staff, interviews with key informants, inter-sectoral CoP discussions, and audits. The intent was to provide a critical framework for the planning and implementing of best practice action, taken with a view to improving care/care continuity for people with dementia who were dying.

This paper presents the conceptual framework of a CoP and key findings from the baseline evaluation, which will demonstrate the current status of practice in this area and relevant family carers’ experiences. The paper concludes with a discussion of strategies developed by the COP to address how current practice could be enhanced.