Changing end of life care

Australians are living longer than ever, and as a consequence often experience a range of medical complications towards the ends of their lives. Current practices in end-of-life medical care require major change to ensure more Australians experience ‘better’ deaths, according to a panel of medical, ethical and legal experts.

Following a one-day forum sponsored by the Schools of Population health at Monash University and The University of Melbourne earlier in the year, the panel issued a comprehensive discussion paper and blueprint for change.

Head of Monash University’s School of Public Health and Preventive Medicine, Professor John McNeil said the forum had been organised to address the changes wrought by an ageing population and rapid technological advancement that now enables doctors to treat many medical ailments into advanced years.

“Therapeutic and technical advances have improved and extended lives of many Australians, but at a cost - a new older generation of people is living with more complex disease and gradual decline in quality of life.” Professor McNeil said.

“This creates new challenges for medical practice in particular; balancing the imperative to ‘cure’ with the personal, social and financial burden it can create. End-of-life care implies an awareness of this balance.”

Australia has seen a large increase in the numbers of people dying in hospital, with 52% of people dying in hospital, despite the fact that most would prefer to die at home. In 2011, more than 146,000 people died in hospital in Australia.

As these numbers are unlikely to change without intervention, the panel hoped that through education, change of clinical behaviour, clinical leadership, practitioner confidence and hospital procedures they would be able to influence the future direction of end-of-life care.

“The benefits of improving the system are multiple - extending to patients and families where there will be improved quality of life-before-death, medical teams and carers to alleviate psychological, moral and emotional distress and conflict, and an improved allocation of resources within the health care system more broadly,” Professor McNeil said