industry & policy
ends up calling an ambulance, going
into an emergency department, then
remaining in acute care and not
getting home.”
THE FUTURE OF HOSPICE IN THE
HOME IN AUSTRALIA
The funding for the project is coming to an
end in December. The District Nurses team
has been busy presenting the results of the
program to the government through the
Productivity Commission and federal and
state budget submissions.
Macgowan says: “We would like to see
a consistent approach to palliative care/
end-of-life care across Australia and for
the Australian government to now look
at introducing a model of care across the
country that supports people to remain at
home and takes that burden away from the
acute care system.”
The Australian College of Nursing (ACN)
has echoed that call. Chief executive
Adjunct Professor Kylie Ward says it’s
time to investigate how to enable trained
healthcare 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 is support must be
provided so all Australians are given
the right to die in the place of their
choosing.”
The college says hospice@HOME
and programs like it 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
healthcare savings.
“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,” Ward says.
According to Macgowan, the program
has been so cost effective that the service
was able to run it for an additional year
to the three for which the funding was
allocated.
On top of that, she says the program
has saved the Tasmanian public
hospital system an estimated $12.4
million since its inception in 2013.
“Added to that is the incalculable cost
of all these families who, after the
death of their loved one, are not in
that terrible bereaved, traumatised
state where they wish things had been
different and are exhausted from
travelling to hospital.
“What our families tell us is that
because they’ve been able to
contribute to that end-of-life period
and give Mum [for example] a good
death, and a death surrounded by her
loved ones, they’re in a better place
as well.”
Ward says: “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 healthcare 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.” ■
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