Love and care given till the end

They treated Mum in a way that came from the heart. A way that would not be taught in training. They stroked her hair, massaged her feet, and spoke to her as if she was their mother. They told her they loved her too.
~ Comments from the family of a Liscombe House resident who died recently after being palliated.

Shaaron Robilliard is protective of her residents and doesn’t like them leaving her care, especially in the last days of their lives. It’s the reason she’s so determined that the palliative care team at Liscombe House, OCAV’s aged care facility, receive the most up to date training and support.

Shaaron, the Director of Nursing & Quality Manager at Liscombe House, knows that caring for someone at then end of their life is about more than procedures and care plans, its also about compassion and kindness. Importantly, Shaaron believes families and residents need to be included in the end of life care discussions from the time the person enters Liscombe House.

“We develop a care plan for each resident as soon as they step through our doors. That plan will include their wishes for end of life. I fight hard to keep them at Liscombe House because it is their home and we can look after them better than anywhere else,” Shaaron said.

In the past year 12 patients were palliated at Liscombe House and only two went to a hospital where they died. Very few people leave the aged care facility to die, a fact that defies the national trend. During Palliative Care Week (May 21 to 28) figures from the

Australian Institute of Health and Welfare (AIHW) revealed that hospitalisations for palliative care are growing faster than all hospitalisations. The figures also showed that, before their death, a greater proportion of people are accessing palliative care services in hospital. Between 2010-11 and 2014-15, palliative care-related hospitalisations rose by about 19%. This is greater than the 15% increase recorded for hospitalisations for all reasons over the same period.

Shaaron said the delivery of palliative care requires a lot of commitment from the OCAV management, and dedication and hard work from staff, particularly the palliative care team.

In the past month four staff have been to external placements including home care palliative care with the Banksia Palliative Care Service. Two nurses spent time in the Olivia Newton John Cancer Centre at the Austin Hospital.

One staff member said: “The palliative care placement cemented my passion for palliative care and reinforced the importance of palliation to achieve a comfortable, painfree, good death.

In the coming month, Jane Newbound from the Palliative Care Consortium will run a ‘when to start palliative care’ forum, working with staff helping them examine their own feelings towards death and end of life care and how that influences their practice. Staff receive regular training on drug administration, recognising symptoms, working with families and understanding a patient’s rights and the family’s wishes.

The palliative care team, which includes a registered nurse 24 hours a day, looks at more than just the medical side of palliation. Staff try and create a warm and welcoming space for the patient and their family who may spend many hours and days in the patient’s room. Staff made a beautiful appliqued quilt to replace hospital blankets, families are served tea and coffee in lovely China tea cups and saucers and music is played on request.

“We are always sad when one of our patients is taken to a hospital to die. Often it is because the family doesn’t understand the process or they think more can be done for their loved one in a hospital setting. That isn’t the case,” Shaaron said. “They are like a part of our family and we look after them very well. We hate to see them leave us to die because we want to care for them.”

“We have doctors here at Liscombe House four days a week and they know the patients, what stage they are up to and what will be needed. Our staff uses all that information when we are preparing the palliative care plan. There is a treatment pathway that we follow, treating the person’s pain as well as their anxiety and a lot of associated needs such as turning the patient very regularly in their bed,” Shaaron said.

If more support is needed, the Austin Hospital’s palliative care outreach team will come to Liscombe House.