This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive Care! For more information visit www.intensivecareathome.com.au
In last week’s blog I was talking about that “Nelson Mandela is receiving Intensive Care treatment in his home!” If you haven’t read the blog, you can access it here http://intensivecareathome.com.au/nelson-mandela-receiving-intensive-care-treatment-home/
Sadly, though, Nelson Mandela has passed away on the 5th December in his own home, whilst receiving Intensive Care in the home services. Thankfully he was able to die in a place where him and his Family felt at peace and he didn’t die behind sterile Hospital walls! Many of his accomplishments live on and will never be forgotten!
In this week’s blog I want to pick up on a recent discussion, led by the Schools of Population Health at the University of Melbourne and Monash University earlier in the year. The meeting identified the need for improvement in end of life care and the associated barriers and drivers for change. In their position paper issued last month they are opting for “Calls for changes in end of life care”. You can find a link to the original article at the end of the blog.
An increasing number of people want to die at home if given a choice!
In summary, the paper highlights that more than 52% of Australians currently die in Hospitals, despite the fact that according to some surveys around 70% of Australians would prefer to die at Home. In 2011 alone, more than 146,000 people died in Hospital.” A fairly large number of those people would have died in Intensive Care!
The benefits of improving the system are multiple, extending to Patients and their 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 one of the panel members said.
How can we meet the challenges with end of life care?
Current practices in end-of-life care require major change to ensure more Australians experience “better” deaths, according to a panel of medical, ethical and legal experts.
“People are living longer and consequently the practice of medicine and the way we live and die has changed,” Professor McNeil has been cited.
“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.”
A shift towards more home care would make perfect sense!
Certainly over the many years working in Intensive Care I have seen many Patients approaching their end of life slowly, often on a ventilator. In order to improve those Patients and their Families Quality of Life before death, a shift towards a more home care based approach even in an area such as Intensive Care would only make sense.
I have also seen many Patients and Families in Intensive Care over the years who have asked for their loved one to go home and approach their end of life in their own home and achieve peace of mind in their own familiar surroundings.
A lot more is possible at home than current clinical paradigms suggest and with successful models of INTENSIVE CARE AT HOME services overseas to look up to, we should start looking outside of Intensive Care in how we can improve Patients and their Families Quality of-Life before death, whilst also looking at more efficient resource management within Intensive Care!
Albert Einstein once famously said: “You can never solve a problem on the level on which it was created.”, hence looking outside of Intensive Care into a more Home Care based approach might improve Quality of Life before death for Patients and for Families.
What are your thoughts? Do you think that “Calls for changes in end of life care” are going to be a reality soon and how do you think it will impact on Intensive Care? Leave your comments here.
As this is the last blog for this year I want to wish you and your Families a merry Christmas and a Happy new year and I’m looking forward in working with you in 2014!
If you want to discuss your needs and how we can help your Intensive Care Unit and your long-term ventilated Patients and their Families and if your organisation wants to free up ICU beds or if you simply have any questions, give me a call on 041 094 2230 or simply send me an email to [email protected].
This is Patrik Hutzel from intensivecareathome.com.au and I’ll see you again in another update next week.
Here’s the link to the original article.
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