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The views and opinions expressed in our blog series are those of the authors and are not necessarily supported by CareSearch, Flinders University and/or the Australian Government Department of Health.
In my role managing two aged care homes in Melbourne, I have come across a number of challenges which needed to be overcome. I took over one home four and a half years ago and the second 18 months ago, discovering the same basic issues in each home; after the first time, the issues were relatively easy to change. Staff were fractured in the sense that departments did not necessarily rely on each other and work together, and knowledge of clinical issues was only handed over to clinical staff, not to the whole home (not an unusual happening). My idea of sharing with all staff was greeted with a degree of scepticism at first, but staff embraced it quite quickly and then started to discuss things across different departments.
For this discussion, aged care refers to the additional care required for an older person needing regular health professional input either in the community or in an aged care home.
Palliative care is, according to the WHO (World Health Organisation), ‘an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual’.
Many people spend the last stages of their lives in aged care, and for that reason Palliative Care Australia believes that end-of-life care should be recognised as core business for residential aged care. Increasingly, aged care providers are recognising the need to ensure their workforce have the necessary skills and competencies to deliver high quality end-of-life care. Yet in spite of this recognition, access to quality palliative care services is far from guaranteed in residential aged care – particularly in rural and remote areas.
We all want the ‘best death possible’ for our loved ones and ourselves as we enter old age. So we need to ask ourselves, what are the barriers to accessing care that can support this, and will looking at the issue from a population or needs-based policy perspective help to ensure end-of-life care becomes core business for all aged care providers?
One of the statements we commonly see in research reports and in policy and service documents is a comment about an ageing population. The reality of a demographic change where people are living longer than ever before has been instrumental in driving rethinking around issues such as retirement age, superannuation access, healthy lifestyles and supportive living environments. Living longer does not however mean living forever, and an ageing population means we also need to consider how we support older Australians as they approach death.
Wandering around your city or town, have you ever seen ‘pop-up’ chalk boards inviting you to contribute your thoughts on an issue affecting us all? If you were asked what one thing you’d want before you die, what would it be? Travel to a dreamt-of place? Marry your beloved? See your grandchildren born? See Collingwood win the AFL Grand Final (go the ‘pies!)?
Chances are you’ll see a ‘Before I die, I want to…’ board somewhere (Before I Die website). It’s an initiative that encourages open dialogue about death with the hope that it will engender compassion for those in our community who are living with a life-limiting illness. It’s a bit like a bucket list, really.