A look at dying well

2 June 2016

It is the last thing that you will ever do, so why not do it well?

The Grattan Institute, a Melbourne think tank, issued a report on dying well. The report shows that, although 70% of people want to die at home, only 14% do. Well worth a read but since you probably don’t have time, we have picked out the best parts for you.

The key recommendations of the report are:

  1. Implement a national public education campaign on the limits of health care and end-of-life decision making.
  2. Ensure end of life discussions and plans occur by introducing incentives and services at relevant touch points (e.g. 75+ health reviews and entry into care).
  3. Better coordination and implementation of end-of life plans to make sure end-of life plans are followed e.g. legalise them.
  4. Provide home based support for carers to support people to die at home rather than in a hospital or a residential facility with an additional 39,000 palliative care services which would be overall cost neutral.

But more interesting than this are the findings on what a good death looks like. Here is what they say, taken in turn from Smith, R. (2000) ‘A good death’, British Medical Journal, 320 (15 January).

  • To know when death is coming, and to understand what can be expected
  • To be able to retain control of what happens
  • To be afforded dignity and privacy
  • To have control over pain relief and other symptom control
  • To have choice and control over where death occurs (at home or elsewhere)
  • To have access to information and expertise of whatever kind is necessary
  • To have access to any spiritual or emotional support required
  • To have access to hospice care in any location including home, not only in hospital
  • To have control over who is present and who shares the end
  • To be able to issue advance directives that ensure wishes are respected
  • To have time to say goodbye, and control over other aspects of timing
  • To be able to leave when it is time to go, and not to have life prolonged pointlessly

This fairly summarises what our clients tell us. Let’s hope this report gains some traction.

If you wish to read the full report, you can find it here: http://grattan.edu.au/wp-content/uploads/2014/09/815-dying-well.pdf

This article was published by Sara Cook and Margaret Harrison, Directors of Signpost Aged Care Services.

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