Chronic disease: the challenge of care and resource allocation for palliative care

The majority of palliative care patients accepted onto our service have a malignancy as their primary diagnosis. As society ages, chronic disease will consume a larger component of health care resources. Patients with chronic disease have a significant and complex symptom  burden, including pain, dyspnoea and psycho-social distress. Compounding this difficulty is prognostication. The majority of elderly patients with chronic disease will die in the acute care hospital setting without the support or input from a palliative care service. They may be denied the holistic care that palliative care has to offer. Palliative care services struggle in deciding which patients with a chronic illness are accepted onto their service. How do we decide when a patient with severe COPD is suitable? How will we deal with the avalanche of frail elderly people? What are the care needs for a patient with a neuro-degenerative disease (eg MND)? Can a palliative care service cope with a morbidly obese patient with chronic: ventilatory failure? This presentation will explore these issues in depth, will provide examples of care, tools to help assess patients with chronic illness and extend the challenge to palliative care services and Palliative Care Australia to accept these patients under their care, and make representation to funders/government to improve the resources to ensure adequate and holistic care to all patients with an illness, not just those with a definable malignancy.