The Australian College of Nursing has called for a national conversation about palliative care and a focus on ensuring people with life-limiting illnesses receive the personalised care and support they need.
Launching its white paper ‘Achieving Quality Palliative Care for All: The Essential Role of Nurses’, ACN CEO Kylie Ward said, “The death of someone we love is exceptionally difficult to face, and I think that has made it challenging for us as a nation to have frank and fearless policy discussions about how we care for people who are confronting their mortality.”
“Palliative care should be provided throughout our health care system – in general practices, aged care facilities, in the community and even in people’s own homes,” she said.
Demand for palliative care services growing, becoming more complex
Seventy per cent of the 160,000 deaths in Australia each year are due to expected causes, and therefore those people could receive palliative care.
In addition, the needs of those receiving palliative care are becoming more complex, as Australia’s population ages. In the five-years from 2011-12 to 2015-16, there was a nearly 30 per cent increase in hospitalisations for palliative care.
Palliative care needs to be integrated into care earlier
The white paper says a nurse-led model of care is the key to ensuring palliative services improves quality of life, reaches more people, and is cost effective.
Distinguished Professor Patsy Yates FACN, told HelloCare, “People who are dying have complex physical, emotional, social and spiritual needs.
Nurses “are well placed to ensure people who are dying receive comprehensive, holistic care that address these complex needs,” she said.
“They often need care over extended periods of time from a range of different care providers. Nurses provide holistic 24/7 care across all care settings.”
“We need to develop and resource models of care that ensure more proactive and individualized approaches to care delivery for all people at end of life,” Prof Yates said.
“This means that palliative care needs to be integrated earlier into the care trajectory for many people. Such models will require an appropriately qualified and supported nursing workforce,” she said.
Australia does not have enough palliative care services to meet demand
Prof Yates said Australia needs more palliative care services, and does not have the staff to meet demand.
“There are many people in Australia who could benefit from palliative care and do not yet receive it,” she said.
“The demand for palliative care will increase significantly as the population ages. This requires a workforce where all health professionals have some knowledge and skills in palliative care, as well as sufficient numbers of specialists across all health professions.
“We do not yet have the numbers required to meet this demand, especially across rural and remote areas of Australia,” she said.
Regional and remote areas should have access to quality palliative care
Prof Yates said palliative care services should be available to help people die close to home, even in remote and regional areas.
“It is important that we are able to support people to die close to home wherever it is possible, she said.
“But we must ensure that they receive the same standard of care as those living in metropolitan settings.
“Some of the best models for supporting rural and remote palliative care delivery ensure strong partnerships between specialist services and generalist services for consultation and capacity building.”
Remote and regional centres have to find innovative ways to access the palliative services they need, Prof Yates said.
“Technology can be important to enable access to specialist services,” she said.
“It is also important to look at local community capacity such as through community agencies as such community supports can often be mobilized to provide the social, practical and emotional supports needed for the person who is dying and their family.”
“The impact of death in small communities can also result in significant grief. It is important that bereavement support is part of services for this population,” said Prof Yates.