Australia has a growing and aging population, with palliative care services around the country busier than ever. It's provided almost anywhere that health care is available, including neo-natal units, acute hospitals, and aged care homes.
And what is on offer compares pretty well globally, according to those in the industry. Cancer Council Australia CEO Sanchia Aranda told PM although there was less home palliative care available in Australia than in the UK, we do better than the United States.
Professor Aranda got a very personal insight into the process last year when her niece died of cancer at home. She had a considerably difficult death but was still able to be at home by the provision of things like a syringe driver, which is a medication pump that you can just pop under the skin.
Improving palliative care in nursing homes
Palliative care is not just about dying at home. Felicity Burns, a community director from Hammond Care, said while most people in Australia say they want to die at home, many change their minds as their situation changes.
Most people in Australia will tell you their preferred place of death is home, but we also know that changes. The exact models of palliative care differ across Australia, with each state and territory having a different approach to providing the services.
As well as in the home, it can be provided in a hospital, in a hospice, and in residential aged care facilities. Ms. Burns said Hammond Care was looking to strengthen the link between palliative care and nursing homes.
They just completed a project where we looked at trying to upskill the residential aged care nurses in palliative care. They need to make sure that the patients in residential aged care are receiving good palliative care.
In 2015-2016, more than 50% of those in the hospital for palliative care were people aged 75 and over. But Felicity Burns said it was younger people under 60 with a terminal illness who often fell through the cracks. Currently, there are younger people in residential aged care facilities, which I think can be very challenging for the person, for their family, and for the other residents.
Quality of care varies
Stephen Duckett, the health program director at the Grattan Institute, and said the quality of palliative care services across Australia varied greatly from state to state and between rural and urban areas.
He said the first step to improving areas of care was acknowledging there were some problems. What we know is that people are missing out on palliative care. Even though many agencies are being funded, they are not being funded keep consistent data and to make that data publicly available.
If people get access to palliative care early, they actually live longer. But we also know that people who get access to palliative care use hospital services less, they use emergency departments less.