When someone is dying, let’s make them as comfortable as possible. Dying in pain for a human is inhumane.
-carer of person in residential aged care
Palliative Care is more than you think...
This week marks National Palliative Care week on the health calendar, with the theme “Palliative Care… It’s more than you think”.
Palliative care helps people living with a life-limiting illness to live as well as they can by managing pain and symptoms to ensure their quality of life is maintained. Good pain management is one of the central pillars of good palliative care.
Managing pain at end-of-life is an important consideration and a vital part of the provision of palliative care. The complexity of pain management is a challenge for professionals, but particularly more so at the end of life juncture.
Even though pain is an individual complex experience, it is supported by different physiological, psychological, and spiritual factors. This why end of life care requires much more than dispensing analgesic and other medication to manage pain. The right palliative care can also identify and treat symptoms which may be physical, emotional, spiritual, or social.
For patients receiving palliative care, maintaining relationships and continuing normal daily activities are just as important, if not more so, than symptom control. This premise is the cornerstone of successful palliative care.
Ensuring the availability of high-quality palliative and end-of-life care services in aged care facilities and people’s own homes, will enable more older Australians to have a good death, better support their families and carers during the dying and bereavement processes and facilitate the better allocation of scarce health resources. In practice however, very few Australians are achieving this.
A new report released by KPMG and Palliative Care Australia this week shows that just 2,595 individuals received a Medicare Benefits Schedule (MBS) funded palliative care home visit in 2017-18, less than two per cent of the deaths in that period. Just four to 12 per cent of Australians die at home, despite the majority of people preferring to spend more time at home in their last months of life. KPMG estimate that the cost of death in Australia is $7.8 billion per year, with more than half, $4billion, in hospital costs.
The report makes many recommendations which are not new such as facilitating people to live well at home in their last months; ensuring advance care plans are completed and followed; providing integrated palliative care that allows individuals to seamlessly access services; and significantly increasing the number of palliative care specialists in residential aged care facilities. These themes are consistent across much of the previous research. The interventions presented can also significantly reduce the hospitalisation costs of dying by nearly 12 per cent, or $460 million per year, while also improving the quality of death.
These recommendations also align well to Goal 4 of the National Strategic Plan for Pain Management, which aims to develop best practice ‘models of care’ to provide pathways for pain management in all communities, even those without pain services, and in settings where new models for pain management are required including palliative care and aged care.
Like the National Action Plan, the recommendations of this report really are just about investing in the well being of all Australians with the twin goal of collectively saving on enormous health costs. These are ‘win-win’ opportunities and for causes we can all support.