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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 spring each year, postgraduate students from all around Australia leave family and work responsibilities to spend 2 intensive days at Flinders University in Adelaide. These professionals come to interact with peers and facilitators to learn more about communication at the end of life, the topic covered as core in all of our courses.
Communication, the cornerstone of excellent end-of-life care, is that delicate skill that can flourish in the fertile environment of mindful practice and supportive critique.
The aim of modern palliative care, whether provided by generalist, or specialist service providers, is to support palliative patients to live and die within the context of their lives, in the setting of their choice, with symptom control and a pattern of care that is supportive of patients’ caregivers.
Most Australian palliative care patients prefer to be cared for at home and the majority want to die at home, though only about 16% of Australians achieve that wish . While there is no nationally consistent data on the volume of community services providing palliative care, it is known to be limited .
August 8th is Dying to Know Day – a campaign that encourages people across the country to engage in meaningful conversation around death, dying and loss by hosting events in their local area. This is its 5th year running and it has clocked up over 403 individual events!
So why on earth should we talk about death?!
Many cultures around the world have a different approach to death. In many countries, people generally die at home surrounded by their community, it is an important time for a community to gather and support each other. Death is not a scary thing to talk about because people have seen the process over their lifetime, they are familiar with the rituals and traditions so they know exactly what to expect and how to respond.
Health professionals need to know the law that governs withholding and withdrawing life-sustaining treatment. Law is not at the centre of the clinical encounter, but it is part of the regulatory framework that governs these decisions. Failure to know and follow the law puts health professionals and their patients at risk. But we know there are gaps in health professionals’ legal knowledge in this area and this is not surprising either, given how complex and difficult this field of law is.
As a young doctor I spent some time working in a palliative care hospital in the early 90’s. It was such a privilege to be working with people at end of life - with the opportunity to make a difference to quality of life and well-being of patients, and their family members. That experience made me decide to devote my career to Palliative Medicine.
I had some experiences at that time that stayed with me.
I had a patient, Marion, who had been a school principal. Marion had suffered a severe stroke. She had survived but was very incapacitated, confined to bed and unable to communicate. She was being kept alive, surviving on a feeding tube, and facing a life of care and dependence. Her specialist was very committed to her survival.