Help the dying to ‘live’

Note to all aged and community care staff: Please place more focus on enabling the dying to live until they can no longer.

Above: Senior occupational therapist at Peninsula Health (Vic), Deidre Morgan, presents at Diversity 2011

By Yasmin Noone

Health care staff do not place enough focus on helping the dying to live well until the moment that they die.

This statement was made by Peninsula Health’s senior occupational therapist, Deidre Morgan, at the Diversity 2011 – 11th Australian Palliative Care Conference in Cairns last week.

Ms Morgan said that medical professionals, hospitals and aged and community care staff mistakenly consider palliative and terminal care to be interchangeable terms, only associate palliation with the last days of someone’s life and indentify palliative care with the “black vans that take people away”.

What’s more, she added, the delivery of palliative care in hospital and aged care settings is currently delivered in an “ad hoc way, if at all”.

However, she stated, differentiation between the two terms is essential because an accurate definition will influence funding, care provision and how others see the palliative care discipline.

“I don’t believe we focus enough on helping people to live the life that remains,” Ms Morgan said.

“Palliative care is not always synonymous with terminal care. While end-of-life care is an important part of palliative care, [it is not just end-of-life care].”

To correct these prominent misunderstandings, Ms Morgan stressed that health care workers must look at palliative care practices through a “different lens” – one which emphasises the importance of life in the face of death.

“The lens we look at palliative care with has a huge impact on the care we provide and the care that patients access.”

Functional decline, she concluded, underpins the end-of-life care tools used in palliative care. If the sector looked at palliative care through a “rehabilitation lens”, staff and medical professionals would be able to “see” the patient and their needs and as a result, place more focus on enjoying an active life and dying well.

After all, she said, “accepting that death is imminent does not mean giving up… Palliative care is an active process”.

Staff should therefore always look at ways to reduce functional decline and safeguard dignity.

But, Ms Morgan stressed, if functional decline is irreversible staff must do all they can to relieve suffering, and employ symptom control management and psychosocial coping techniques at the end of life.

“The antithesis of palliative care is the inability to participate, which is detrimental to wellbeing.

“So palliative care should aim to manage pain symptoms and maximise function, especially as a person approaches death.

“When we do these things, we don’t think twice because what we are doing seems ordinary to us… but it is extraordinary to a person who’s trying to keep participating in life. What we define as ordinary consequently acquires new meaning at the end of life.”

Tags: 11th-australian-palliative-care-conference, death, deidre-morgan, diversity-2011, dying, end of life, palliation, palliative care, peninsula-health, rehabilitation,

1 thought on “Help the dying to ‘live’

  1. To Deidre Morgan,
    Thank you for presenting this important issue so clearly. There is definitiely not “…enough focus on helping the dying to live well until the moment that they die.”
    As a Diversional Therapist ( Lifestyle) with over 10 years in Aged Care, it amazes me that although 1 of the 4 Aged Care Accreditation Standards pertains to LIFESTYLE, (which includes outcomes such as leisure interests and activities, choice, independence, cultural and spiritual life)extrordinarily little attention is paid to it. The medical model of care is certainly entrenched when the average aged Care facility employs lifestyle staff to a level of 1hr of staff per week for each resident. How sad. This is probably as result of the incongruity between the funding instrument (ACFI)and the accreditation Standards, where the former provides no assessment for standard 3 despite the diversity of such support needs for a person at the end of life. Consequently,I believe many CEOs focus their efforts and limited staffing on care that draws funding.

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