The Australian College of Nursing (ACN) is calling on the Commonwealth Government to ensure Australia’s health care system respects and keeps pace with changing patient preferences, in particular a person’s wish to die with dignity in their own home, surrounded by loved ones.
“We have delivered health care in this country in essentially the same manner for decades, which generally sees patients moved into care facilities, hospitals and hospices as they grow frail and end stage,” Australian College of Nursing Chief Executive Officer, Adjunct Professor Kylie Ward FACN, explained.
“While we are fortunate enough to have one of the best health systems in the world, we must not become complacent and opposed to consumer-driven ways of delivering care. In particular, we must constantly work to make sure we are delivering health care in the manner and place that is best for individuals.
“People’s preferences change. We can see this in the increasing desire Australians have to age in place, and now we know they want to extend this to being supported to die at home.”
Seventy per cent of Australians would prefer to die at home (Swerisson and Duckett, 2014), but currently only around 14 per cent of people do so.
“We want to see patient choice improved through increased support for in-home palliative care,” Adjunct Professor Ward said.
In Tasmania, a four-year hospice@HOME program has shown the significant benefits of giving people greater choice and control regarding their end-of-life journey.
hospice@HOME is being delivered by The District Nurses and Chief Executive, Kim Macgowan, will be delivering a presentation on the project at next week’s ACN National Nursing Forum 2017.
“Programs like hospice@HOME demonstrate that in-home palliative care not only enables people to stay in an environment where they are comfortable and with their family and friends, but offers significant health-care savings,” Adjunct Professor Ward said.
“The Tasmanian experience shows that providing palliative care in a person’s home costs around $39 a day, yet a hospital bed costs $1500 a day.
“Research suggests that about 30 per cent of health-care costs are attributed to the relatively small per cent of the population who sadly pass away each year (Banarto, McClellan, Kagy and Garber, 2004), and that the more we spend, the more we actually decrease a person’s quality of life in their final days.
“It is time for us to investigate how we can enable trained health-care professionals to provide end-of-life care in a person’s home.
“States and organisations are currently successfully delivering this type of care in locations around the country, but what we are saying today is support must be provided so all Australians are given the right to die in the place of their choosing.”