With 52% of Australians dying in acute hospitals, end-of-life care is essential knowledge for health care professionals.
However, health care professionals working in acute hospitals can find themselves challenged by patients with end-of-life care needs. Doctors, nurses and allied health professionals can be in a situation where they do not know how to best respond to a patient with end-of-life needs. Appropriate end-of-life interventions can be missed.
I’ve always been interested in how technology is evolving and how it is affecting our personal and our working worlds. Technology has changed and is continuing to change how we access information, how we communicate, what we create and what we leave behind. So preparing a module on digital dying for our MOOC, Dying2Learn, gave me a wonderful opportunity to explore a number of different aspects of death and dying that have been influenced or changed by digital technologies.
Some things are immediately obvious. Digital technologies have changed much of health and there are now amazing avenues for assessment, treatment and research that were not available a generation ago. If you are interested in the big picture approach to digital health, I’d suggest you take a look at Ste Davies’ presentation 10 digital health trends for the next 20 years or check out The Medical Futurist, who likes to pose grand challenges for the digital world and transforming health.
This is one of the questions that will be addressed in the Dying2Learn MOOC. As a palliative care doctor, it has been wonderful to have the opportunity to start this conversation, and I am looking forward to the interactions with real anticipation.
In developing this section of the MOOC I have tried hard not to assume too much about what participants should think or believe, or to push any particular perspective. Obviously that is a bit difficult for me, as my work for over a decade has been in the smoke and dust of the clinical battlefields where dying patients often end up i.e. acute hospitals. As palliative medicine clinicians we often feel like we are galloping in to rescue people from the hospital system, and (speaking for myself, anyhow) we can sometimes be a bit black and white about things. What I have learned though, over and over again, is that it is not simple for people. Many are unprepared for the decisions they will need to make, and - like BREXIT perhaps!- may not fully understand what they have let themselves in for until it is too late. The implied consent that comes with agreeing to a course of treatment may lead to a conveyor belt of care with no obvious jumping-off point. In my experience, default clinical treatment is actually not a good way to look after people who are dying. It may not offer choices that allow people to get out of hospital, it may not help people to understand what is happening to them, it may not do enough to ensure people are comfortable, and it simply may not allow them to do what is most important to them when their time is getting short. Often, it is just not kind. That’s my point of view. But in this week of conversations we will be really keen for people to explore what they know, what they fear, or what they have witnessed themselves, and to figure out their own approach to this death and dying thing.