Katrina's in there till the end

Katrina Garnsey has travelled a long way to work every day for 18 years. The palliative care resource nurse travels to OCAV’s aged care facility at St Helena from her home near Ballarat. And she wouldn’t have it any other way.

For almost two decades she has cared for the residents who spend the last stage of their life at OCAV. She and the rest of the team at Liscombe House, especially the nurses who have participated in palliative care education, work hard to ensure a resident’s last days, and sometimes weeks, are as peaceful and special as possible, for the family as well as the resident.

“I have had experiences with family members dying at other aged care facilities and I know that we do it better. We try and ensure that everything possible is done for our residents who are dying. We are committed to person centred care and ensuring each person’s wishes/needs are met. It’s not just their pain relief we focus on, though that is very important, it’s also about the people around them, their family and friends,” Katrina said

Katrina started with OCAV as a personal care attendant when the Residential care was located at the Rushall Park village in North Fitzroy. With OCAV’s support she studied nursing at RMIT over two years and then completed her palliative care resource nurse training at Banksia Palliative Care so that she could play a greater role in the care of dying residents. It’s a job that many might shy away from, but not Katrina.

“As a teenager growing up in Tasmania I always wanted to do nursing, but other things got in the way,” Katrina said. “So when I had the opportunity to do it when my children got older I grabbed it and I’m so glad I did. Caring for older people, especially as they come to the end of their life is the greatest privilege anyone could ever experience and I want to make sure we do it as best we can at Liscombe House.”

Last year 19 residents were palliated at Liscombe House and the staff prefer it that way, wanting to care for people who are part of their community, rather than see them leave at the end. Staff are well equipped to care for them with ten staff completing external training in areas such as the palliative approach or looking at the terminal care pathway with Banksia and Northern Hospital; five staff have completed Advance Care Planning at the Austin Hospital; and one staff member has completed a train the trainer program in Advanced Care Planning.

Liscombe House has procedures and polices that are implemented as soon as staff recognise that a resident’s health is deteriorating. A doctor assesses the resident and the resident’s family is also brought into the palliative care treatment pathway at the start.

While the palliative care pathway is a medicalised plan, the residents’ well being, personal likes and dislikes and the needs of family and friends are also taken into account. There are lots of special touches unique to Liscombe House.

“We want to make it as peaceful and caring for the resident and their families, that might spend lots days in the person’s room, waiting. Staff have made two beautiful appliqued quilts to replace hospital blankets. Family members can stay on a foldup bed and we encourage them to be part of the care, massaging their loved ones hands if that is appropriate. We have a Palliative Care Trolley all set up for family members with tea, coffee, and snacks and provide sandwiches or light meals from the kitchen. Music is played if the person wants it, and also we use aromatherapy,” Katrina said. “We are also conscious of the wider Liscombe House community where someone may have lived for years. We accompany their close friends to visit the resident who is dying.”

“It makes a difference that our staff stay a long time. It means they know the person who is dying and they know what they like and don’t like. It adds to the care. There’s a culture at Liscombe House that means mediocre treatment is not acceptable,” Katrina said.

“It’s sad when a resident dies, especially if you have known them for a long time and you get attached. But we are here to do the best job we can caring for them and when they have gone, that’s when we can stop and grieve for them.”

Palliative care at OCAV is not just a clinical issue, it is a whole team effort from management, clinical, support services, maintenance and other residents and families. OCAV has a palliative care team that ensures policies and procedures are best practice and it reviews and evaluates any changes to legislation that may affect palliative care. The team also discusses any possible process improvements.