As the saying goes, the only certainties in life are death and taxes. While many people will freely discuss the issue of tax (usually bemoaning how much they pay), death remains a topic even more taboo than politics or religion.
This reticence to discuss death can contribute to feelings of anxiety and helplessness people may feel as they approach the end of their life. Few take the time to sit with loved ones and carers to confront issues most would prefer to avoid.
Research conducted by Palliative Care Australia (PCA)confirmed this. The 2012 survey of 1000 people found that, while the majority wanted to die at home, only 32 per cent had discussed their wishes with loved ones.
Kerry Whitlock is a quality and compliance officer with Uniting AgeWell. Ms Whitlock said that, in response to the findings of the PCA survey, a comprehensive and easy-to-use Advance Care Plan (ACP) will be incorporated into the palliative care approach taken by Uniting AgeWell.
“It’s a really good idea to start talking about what people want,” Ms Whitlock said. “The conversation takes the ‘elephant out of the room’ and means that you actually know what the person wants. People have a choice, they know their voice is heard and their wishes will be respected.”
AgeWell Palliate is being rolled out in Victoria and Tasmania to both community and residential care providers. The launch in Victoria was attended by 68 staff, including managers, chaplains, care managers and enrolled nurses.
The aim of the program is to initiate discussions on end of life care approximately six months before someone becomes terminally ill.
This can then be revised as the needs of the person change.
As Ms Whitlock explained, an ACP can also assist if circumstances change suddenly and emergency care is needed.
“Most hospitals require some sort of direction of care, especially in a crisis,” Ms Whitlock said. “If you don’t have an ACP there is frustration on both sides, because the ambulances and emergency are overwhelmed and they may make decisions without actually knowing the wishes of the person.”
Although the thought of planning for end of life might be daunting, the ACP is relatively simple to complete. It includes questions on what an acceptable recovery would mean for the person, whether they would want CPR administered and their spiritual and cultural needs as the time of death approaches.
The issue of choice is the main aim of the ACP. It is hoped that with that choice will come peace of mind, not only for the person dying, but for their loved ones.
“The ACP asks for details of a funeral director,” Ms Whitlock said. “In some families you can have a lot of individuals and everyone needs time to sit down and work out funeral arrangements – this is not something you want to do at three in the morning. This allows them to do that research beforehand, if you are informed, you can work out what you want.”