Last week, Premier Gladys Berejiklian opened a new palliative care ward at Gosford Hospital. It is the first public facility of its kind on the Central Coast and has been dubbed “Elsie’s Project”, in honour of the nurse who made it her dying wish.
Elsie’s dream was taken up by a volunteer army, including local businesses, artists and Lions Clubs. After nearly a decade, the campaign succeeded. The palliative unit includes 10 beds and dedicated family vigil space, providing people who are nearing the end with a sensitive alternative to treatment in an aged care setting or at home.
“It’s important residents know they have a choice,” the Premier said. “They don’t have to stress and worry about end-of-life care.”
Palliative care is largely intended to preserve quality of life for people with an advanced disease and little or no prospect of survival (this could include sufferers of cancer, motor neurone disease, kidney failure, dementia and Alzheimer’s). It is staffed by specially trained nurses and allied health practitioners – people expert in providing compassionate and spiritual support, identifying symptoms and managing pain.
As you’d imagine, the news from the Central Coast has been a fillip for local palliative care campaigners.
Today, two of Western Sydney’s biggest hospitals – Nepean and Westmead – lack dedicated palliative care wards. Incredibly, none are planned, despite major upgrades underway and the number of over-65s projected to nearly double across the Parramatta and Cumberland LGAs by 2041.
Westmead’s facility closed in 2009. Since then, some terminally ill patients have been placed in the hospital’s cancer and haematology ward, alongside patients with hopes for recovery.
Thousands more have been referred to in-home providers. Others have been forced to transfer to Mt Druitt or Auburn hospitals, where staff may be unfamiliar with the nuances of the patient’s condition.
It’s a limited patchwork of services, exposing the massive gap between people who require palliative care and those who receive it. Studies show that about 54 per cent of all Australians die in hospital (typically taking up an acute or general bed); another 32 per cent in residential aged care and the rest at home.
Leaving the issue of euthanasia aside, much suffering could be alleviated if more people were in specialist hands at the end. The setting in which we die is deeply personal – as known by anyone who has ever sat by a family member’s bedside. Spending one’s final days at home may be the ideal but also not possible for those with complex medical needs or limited available support.
As Australia’s population ages, new policies to expand palliative care irrespective of location should now be a priority. Surely, dedicated wards should be best practice in all major hospital redevelopments. Greater investment in sub-acute and hospice care also saves money, opening up bed capacity elsewhere in the hospital.
We’ll need to improve palliative care provision in our aged care sector – including by recruiting more trained medical staff to work in nursing homes – and to expand care in the home for those who need it.
As for those campaigning for a palliative care ward at Westmead? Let’s heed the words of Oana McBride, who led the push at Gosford. She wrote on Facebook: “It was a long journey and the road was not smooth. It really takes people power to tell the local health district and the government that it is a vital resource. Keep the conversation alive.”
Alan is a journalist and communications specialist. He writes a weekly column for Parra News.