Home' Australian Ageing Agenda : AAA Spt-Oct 2014 Contents carers may mean the difference between a
peaceful death at home and an unwanted
"There is a lack of well-trained supportive
palliative care workers to work alongside
and under the guidance of specialists to help
terminally ill people to die at home and so
one of the most significant things about this
program is that it is about enabling choice.
This program is giving people a real option."
Most Australians say they want to be
cared for and die at home. Yet across
Australia only 16 per cent of people
achieve this outcome, and more than half
die in acute care hospitals.
At the end of June, Yule says 80 per
cent of people who have died while
receiving a home support package have
died in their homes.
The program, which can deliver up
to 18 packages a week, is targeting
seven LHDs and is a consortium project
involving HammondCare, Sacred Heart
Health and Calvary Health Care Sydney.
Bathurst palliative care nurse Cheryl
Green says the HammondCare packages
have helped take the pressure off families
experiencing high carer stress and have been
flexibly used to suit the needs of the family.
"With a care worker available throughout
the night, families have felt comfortable to
sleep rather than being on constant alert,"
she says. "We have had another instance of
a family carer who hadn't had any respite
for three months and she had missed
seeing her grandchildren, so the hours were
arranged so she could have an outing over a
couple of weekends."
Green says a request for a second
package for a patient needing more than
48 hours of support can be made and the
availability of the packaged support to
families has been fast.
As part of the program, generalist
community workers receive training in
palliative and supportive care through the
Learning and Research Centre at Greenwich
Hospital under international palliative care
expert Professor Rod Macleod and specialist
clinical nurse consultants.
The care workers are trained in pain
and symptom management, the ethics
of palliative care, understanding loss
and grief, and carer wellbeing. Once the
package is approved, the care worker joins
the specialist palliative care team and
is involved in a range of tasks including
personal and domestic care, shopping,
basic nursing care and observation.
One care worker involved in the
program described her experience of
nursing a client in her final hours: "During
the last night Claudia* had lots of discharge
coming out of her lungs and I had to wipe
and change her napkin under her face
frequently. Her bible and songbook were
on her bedside table. I took her bible and
read. After a long time reading I wondered
if I should sing a spiritual song and I did. By
the end of the song, she opened her eye's
wide, moved her shoulders and changed
her breathing pattern."
In the areas where HammondCare does not
have an existing pool of community aged
care staff available, the organisation has
signed a memorandum of understanding
with aged care organisations to recruit
and train their staff to deliver the service.
HammondCare is currently working with
12 other aged care organisations to build
this additional workforce.
"We have partnered with other aged
care providers as recommended to us
by the specialist palliative care teams in
the LHDs," says Yule. "Across NSW we
have now trained 200 community care
workers in palliative care. In addition to
HammondCare staff, we have MOUs in
place with the other organisations where
we don't have a presence. It's been a very
collaborative program," she says.
"We're all working towards the
common goal to support people in our
community to be able to die in the place
of their choice."
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