Residential Goals of Care
The Residential Goals of Care (RGoC) is a clinician-led form completed as part of discussions between a resident and their health care team.
It outlines the resident’s goals and preferences for care, and the type of care and treatments that would be appropriate in the event the resident’s condition deteriorates in the context of end of life (i.e.an illness they are unlikely to recover from).
The healthcare team should support family members, carers and / or representatives to be part of the discussions, if the resident agrees. Where the resident no longer has capacity to make decisions about their goals of care, their recognised decision-maker should be included in any discussions (i.e. Enduring Guardian, spouse, or next person on the hierarchy of treatment decision-makers).
Goals of care discussions and forms are complementary to advance care planning, and do not replace residents’ existing advance care planning documents. Sometimes, goals of care forms can include treatment and options not initially considered when the person prepared their advance care planning documents.
Any residential aged care facilities (RACFs) can adopt and use the RGoC form as a part of their standard practice. It is already in use at some metropolitan and regional RACFs in WA as well as within all aged care facilities in the WA Country Health Service.
How are RGoC forms used in aged care?
The RGoC is implemented in line with the following principles:
- Goals of care discussions support shared decision-making between the aged care team, residents and their recognised decision-maker(s). Even if the resident no longer has capacity to make medical treatment decisions, they may still be able to participate through supported decision-making practices.
- Goals of care discussions are always voluntary and should align with any advance care planning documents the resident may have completed.
- Goals of care forms must be reviewed regularly to ensure they reflect the residents’ current preferences and priorities for care.
- The resident’s medical practitioner / GP and / or nurse practitioner should be involved in or aware of discussions about goals of care and validate (sign) the form.
Do all RACF staff have a role in RGoC?
All RACF staff can support residents to participate in goals of care discussions, however, it is recommended that only RACF clinical staff with sufficient experience, confidence and skill facilitate and document the discussions.
What implementation resources are available for aged care facilities?
There are resources available to assist RACFs and aged care staff implementing the RGoC form:
The Goals of Patient Care education and training resources are also helpful for staff wanting to learn about goals of care conversations and to view communication videos.
RACF staff may also be interested in looking at suitable education and training from the following providers in WA:
Can our facility use the RGoC form with our residents?
If your facility is interested in learning more about the form, or implementing it at your site, please contact the:
Department of Health WA Advance Care Planning Information Line
Phone: 9222 2300
Email ACP@health.wa.gov.au
Last reviewed: 04-06-2024
Produced by
End-of-Life Care Program