Adequately funded community palliative care and end of life planning.

Iam slightly surprised not to see more extensive  comments around this.

Not only would these  sevices ensure patients and families wishes were undertaken but the savings for health care providers make it a win/win for all involved.

I acknowledge we currently have a skeleton model of such services, but without committment and real investment we will continue to be facing the question posed at the start of this article.

Why the contribution is important

Financially, ethically and morally numerous reasons for adequate provision of these services has been / and continues to be raised .

by GoodwiLo on May 29, 2019 at 09:46AM

Current Rating

4.95
Average score : 4.9
Based on : 20 votes

Comments

  • Posted by sankeyb May 31, 2019 at 11:06

    I wonder if the rapid response resources that currently exist for early discharge of post acute patients could be provided to allow timely access and support for EOL patients and their families.
  • Posted by sansomex May 31, 2019 at 11:13

    Person-centred care must surely start with the person. Discussing with a person their wishes, values and preferences for current and future health care and acceptable outcomes should be the starting point and the foundation of all discussions with the person. Advance care planning facilitators have the time, clinical expertise and legislative knowledge to listen to the person, include their substitute decision-makers (where appropriate) and empower a person to discuss and/or document their wishes so they can be known and accessible in all future health situations. The increasing complexity of chronicity and age of the patients in our community, outpatient and hospital services, suggests end-of-life is more able to be anticipated and planned for than ever before. Quality end-of-life care, including in-home or in-residential facility, can support the natural dying process in a person's familiar environment, if that is their preference. Recurrent funding for ACP facilitators is required: to educate staff on decision-making processes and to mentor how to initiate conversations with patients; to support a person to "voice" their wishes, values and preferences, either orally or in writing; to facilitate conversations with family members and the multidisciplinary team if there is potential conflict around imminent end-of-life decisions; to improve knowledge and access to completed and effective ACP documents on The Viewer (thanks to the work of the Office of ACP); and to support ongoing review of health care preferences as health inevitably deteriorates, ideally before cognitive decline. Support for community palliative care and earlier referrals to palliative care, will enable the dying person and their decision-makers and family to be more adequately prepared for dying, and be supported to receive person-centred physical, psychological and spiritual care through dying, death and bereavement.
  • Posted by SutherJu May 31, 2019 at 12:24

    Delivering information directly to community groups empowers people to think early, talk to the people who matter most to them, learn about their health conditions and probable interventions, and write down their preferences according to the quality of life they wish to maintain. Involving more of our community members in advance care planning conversations, with assistance provided by skilled health professionals to facilitate and assist people to prepare documents is shown to lower the number of unplanned, unwanted presentations to hospitals and lengthy hospital stays.
    Recurrent funding for skilled facilitators is necessary to continue participation in advance care planning. It has been clearly shown (see Queensland Health Office of Advance Care Planning data) that there are significant savings to the health system and greater satisfaction for people who communicate their wishes in advance. The flow on effect to ED pressures, hospital bed pressures, clinician dissatisfaction and distress, and, most of all, patient distress as bereavement complications is yet to be fully realised for the whole of Qld.
    We need more skilled facilitators funded to educate all health professionals AND the community about advance care planning.
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