industry & reform
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.”
ACN says programs like hospice@
HOME 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 Mu m [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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