SYDNEY, NSW / Australian Aging Agenda / Health Care / September 8, 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, hospital, aged and community care 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”.
Senior occupational therapist at Peninsula Health (Vic), Deidre Morgan, at Diversity 2011
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.”
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