Managing needs key to end-of-life care

EMPOWERING: Anglican Care strive to involve an individual and their loved ones in the planning for end-of-life palliative care to ensure quality of life.
EMPOWERING: Anglican Care strive to involve an individual and their loved ones in the planning for end-of-life palliative care to ensure quality of life.

Effective palliative care is about  ensuring the comfort, care, needs and choices of each individual are managed at the end of life to  ensure good quality of life.

Once a chronic life-limiting disease is diagnosed it is important that a person gets the treatments and choice in care that they want.

Essential to that is an understanding of each individual and their preferences.

Everyone has different choices for personal, religious or cultural needs and it is critical that in this stage of the life journey the person is happy and that the family are informed

Anglican Care has adopted the Palliative Approach as a holistic and nurse-led care model for all people living in residential aged care and the community with a chronic life-limiting disease.

This approach is focussed on comfort, quality of life and dignity of risk; understanding that as people approach the later years of life and require assistance with daily living, they have choices as to the medical treatment and interventions they find acceptable.

Discussion about advanced care  is  critical  so that each person can have their end-of-life wishes respected and quality of life ensured. 

“The process ideally starts as early as possible after diagnosis when we do up a Medical Order for Life Sustaining Treatment (MOLST),” Anglican Care  Nurse Practitioner in Palliative Aged Care Janean Cole  explains.

“Each person’s trajectory will be different depending on their end-of-life diagnoses.

“A MOLST is a plan that documents a person’s end-of-life wishes and will travel with them to hospital or wherever they might go, informing carers and medical professionals.

“The main purpose is to empower the person and their loved ones to live the way they want at end of life.”

As part of Anglican Care’s commitment to the Palliative Approach, Comfort Care Coordinators  provide leadership and resources to support maximum comfort for all of their residents and consumers. 

“We try to give the individual and their loved ones as much information as possible, so that they can make informed decisions,” Janean said.

Underpinning the provision of comfort care is the understanding that ‘comfort and pain management’ take  priority over ‘cure’ for many people with a life-limiting disease/s and that providing comfort relies on a collaborative approach which brings together medical, nursing, care and lifestyle professionals with a person and their family to explore what comfort means to the person at this stage in their lifespan.

“We do holistic assessments,” Janean explains. “We try and educate people on how it can be affecting them emotionally, the impact on family support systems, psychological counselling at different stages because end of life progresses differently for each person.

”We provide comfort care boxes which have equipment and information that can prepare and aid their journey.

“We give information for families on what to expect and inform them about their progress.

“Sometimes with the emotion it’s hard to take in, so the comfort boxes allow families to take it in at their own pace.”

Anglican Care has 11 residential facilities across the Central Coast, Lake Macquarie, Newcastle and Mid-Coast areas, and also provides home care.

“We try and cover all bases at all points of life,” Janean said. “Some  people have care at home until end of life and our nurse practitioners will go to that home and give that support.

“Or if they are in a residential facility we endeavour to individualise each circumstance so that it feels like home. For example, we’ll fill their room with familiar things, make it smell “normal”, perfume the room with favourite smells, play familiar and favourite music.

“All those little things make a big difference to the individual on their end-of-life journey and the feedback from families on how we individualise those situations is also very positive – it’s a big release for them too.”

Strong linkages to specialised health professionals and services is a key factor in ensuring comfort is maintained right through to the end of a person’s life.

“At the end of life with Anglican Care you have the option to stay at home or within your residential facility, rather than go to a hospital,” Janean said.

“We have strong networks of medical and care professionals.  Many people prefer not to go into the unfamiliar surrounds of a hospital with strangers. Patients can be assessed out of hours by their GP using Telehealth, for example.

“It’s part of Anglican Care’s holistic approach, to make sure the well-being of the individual and their family is being ensured with informed consent. They know the possibilities and make the decision themselves.”