Palliative Care & End of Life Planning

Sadly, many Australians pass away in palliative care facilities such as nursing homes, hospices or hospitals. Sometimes, they can receive end of life care that’s not in keeping with their wishes.

For this reason, all Australians, especially those living with life limiting conditions should plan ahead and let their family, doctors, friends and caregivers know their end-of-life preferences in advance. Once these wishes have been noted, loved ones and caregivers can make informed decisions and take the necessary steps to ensure these wishes are met where possible.

What is palliative care?

Palliative care is specialised medical care for people of any age, living with a serious, life limiting illness. It is designed to enhance and improve quality of life and may be provided on its own or in conjunction with medical intervention.

For some people, palliative care may be beneficial from the time of diagnosis with a serious illness. Palliative care is usually a family-centred model of care, which means that family and carers can also receive practical and emotional support.

Palliative care can be provided in a range of settings including homes, hospitals, hospices and residential aged care facilities. As well as aiming to improve quality of life and help with symptoms, palliative care can help patients understand their choices for medical treatment.

Who makes up the palliative care team?

A palliative care team is composed of a number of health professionals including, but not limited to, palliative care doctors and nurses, dietitians, social workers and chaplains. These people work collaboratively with the patient, their family and the patient's other doctors to provide medical, emotional, practical and social support.

In most circumstances, a patient's doctor will start the process of palliative care via a referral to a palliative care specialist. Alternatively, patients can ask their doctor for a referral to a palliative care service.

In general, palliative care services are paid for by Medicare and/or private health insurance. Veterans may be eligible for palliative care through the Department of Veteran Affairs.

Areas where palliative care can help

As palliative care is based on individual needs, the services offered will differ for each person. They may include:

• Relief of pain and other symptoms such as shortness of breath or vomiting
• Resources including equipment needed to assist care at home
• Support  for families to discuss sensitive issues
• Planning for future medical treatment decisions and goals of care
• Links to other services such as financial support or home help
• Support to meet cultural obligations
• Support for social, emotional and spiritual concerns
• Grief and counselling support
• Referrals to respite care services

If you are interested in finding more information on palliative care, you can contact the palliative care peak body in your state.

What's the difference between end-of-life care and palliative care?

Whilst palliative care is aimed at improving the quality of life of patients with life limiting conditions, end-of-life care refers to the services and support given to terminally ill patients who are in their final stage of life. For example a patient who has advanced terminal cancer.

In contrast to palliative care, which can continue for a number of years, end-of-life care prepares a terminally-ill patient for their imminent passing.

End-of-life planning 

Most people find death a difficult subject to talk about. Nobody likes to think about it, let alone plan for it. However, planning for death can reduce the burden on those you leave behind. Via careful planning and care, you can help reduce arguments and stress and ensure your end-of- life wishes come to fruition.

• Some of the common questions you might want to discuss include:
• Where do you prefer to pass away? At home, hospice or hospital?
• What are your ‘goals of care’? These can be developed with your treating doctor or general practitioner.
• Who do you want with you when you die?
• What do you want included in an advance care plan or directive? For example, you can include instructions regarding artificial respiration or nutrition, as well as who your substitute decision-maker is if you are unable to speak for yourself. 

Some additional end-of-life matters to consider include enlisting the services of a death doula, writing documents such as a legally binding Will and, if you haven't already done so, planning your funeral. 

Planning your funeral

Planning for your own funeral can be daunting and upsetting, but it will be even harder for your family once you pass away. Pre-arranging your funeral is one of the best things you can do for your family during one of the most difficult periods in their lives.

• Some things you might consider when planning your funeral include:
• What sort of service would you like? A cremation or burial?
• If cremation is preferable, what would you like done with your ashes?
• Would you like a religious or non-religious service?
• Would you prefer a traditional or non-traditional memorial?

Wrap up

There are so many choices and decisions to be made, hence why planning is so vital. Take the time to consider the information covered in this article. Perhaps now is the time to sit down with friends, caregivers or family to discuss your end-of- life wishes.

When you are ready to write your legal Will or plan your funeral, the friendly and experienced team at Willed can help.