In recent times there has been an increase in community conversations around death and dying. These conversations include topics such as how and where we die, the concept of a good death and the need to plan to die well. In Australia, 60 - 70% of people want to die at home but only 14% do. Fifty four percent of people die in hospitals and 32% in residential aged care facilities.
The components of a good death include respecting patient wishes and advance care plans, enabling patients and clinicians to act as partners in care, ensuring integration of services and care, and facilitating open and effective communication.
Many people report experiences where services have been poorly integrated, disconnected and multiple, and the end of life journey has been confusing, distressing and frustrating. Duplications, gaps and delays in care can occur and there is variety in the quality and provision of palliative care services particularly for those living in regional and rural areas. Palliative care services may be poorly integrated with the rest of the health system.
Ways in which the end of life care can be improved could include ensuring preferences are expressed and supported, reducing unnecessary transfers between residential aged care facilities and hospital, improving skills and confidence of non-palliative care specialist staff in providing end of life care and ensuring palliative care services are equally accessible for older people.
This project aims to identify the care services provided to people during their last 6-months of life, report on the degree of integration and communication in the care services provided to people during this time, and improve the integration and communication of care services provided.
A project advisory group has been established with a range of MARC partners with expertise in end of life and palliative care to oversee the project.
In June 2017, MARC is still finalising the protocol and the ethics application ahead of collecting data at hospitals and residential aged care facilities.