Tuesday, 26 June 2012
The introduction of contemporary palliative care services, not just in Tasmania but across Australia, is a cause I have been wholly committed to supporting. Recently in Launceston we held a public forum to help people in our community understand what is meant by palliative care and to gather more support for the cause. The forum was a suggestion that arose from a meeting between the Friends of Northern Hospice and Palliative Care Foundation and me in late 2011. The forum was a cooperative venture organised by Friends of Northern Hospice and Palliative Care Foundation, Calvary Health and me. The forum coincided with Palliative Care Week. This was one of two activities during Palliative Care Week of the Friends of Northern Hospice and Palliative Care Foundation. The other was a remembrance ceremony on the Sunday. I would like to add how supportive Palliative Care Australia was of the activities held across the country.
In the north of Tasmania, there was some disquiet at the closure of Philip Oakden House. There was considerable community financial input into Philip Oakden House as a dedicated palliative care facility, and the closure of this facility caused substantial community angst. The Friends of Northern Hospice and Palliative Care Foundation have moved on from this setback and have a clear agenda to develop comprehensive palliative care services across northern Tasmania. I commend them on their work, commitment and dedication to providing better services to northern Tasmanians.
The weather on the night of the forum was appallingly cold, wet and windy, but despite this almost 100 people still attended. Don Wing, a former mayor of Launceston and member of Tasmania's Legislative Council, chaired the forum and introduced the two keynote speakers. Sue Hanson, National Manager of Palliative Care Services, and Dr Katherine Clark, Director of Palliative Care at Calvary Mater in Newcastle, were the guest speakers. Dr Clark said:
Palliative care is historically linked with care in the last few weeks of a person's life. However, as a community, we must now understand that palliative care should commence as soon as a diagnosis is made.
In Australia and other developed countries, palliative care services have often focused on people dying with cancer. However, palliative care also needs to be available to people dying from non-malignant diseases.
The range of people suffering from different diseases emphasises the importance of the person's needs, rather than their diagnosis, being the key to care. Imagine the complex issues surrounding someone suffering from dementia—and how different the needs of someone suffering from motor neurone disease might be. The more complex someone's needs become, the more important to involve palliative care experts. Recognition of the needs of people who are dying must occur no matter where the person is—hospital, hospice, emergency department, nursing home or their own home.
Both speakers emphasised the importance of the wishes of the individual and that most people preferred to remain at home rather than move to a form of institutional care. They were not saying that this may not be appropriate, but it is generally not the preferred option. What is interesting is that this recognition is similar to that which is occurring across healthcare services generally—the need to support people to stay at home and to help them avoid having to be admitted to hospital. The need for palliative care to be recognised as a specialty area in its own right became apparent in the 1980s. Despite it being shown that the experience of end-of-life care was improved by palliative care, it continued to have a low profile.
There have been two ministerial announcements in recent weeks about support for palliative care services in Tasmania. Firstly, the Minister for Mental Health and Ageing, the Hon. Mark Butler, attended a public forum in Launceston only the week before the palliative care forum I have been talking about and outlined a $21.7 million package to provide better palliative care and support in aged care in a statement about the Living Longer, Living Better report. Secondly, the Hon. Tanya Plibersek, the Minister for Health, announced $74.5 million over four years to provide better care for patients after they are discharged from hospital and better palliative care in the community as part of the health package for Tasmania.
An interesting comment was made by Grant Musgrave from Calvary Health. Calvary Health supported the forum and have been very supportive of hospice services in Northern Tasmania following the demise of Philip Oakden House. Grant Musgrave's comments suggested a direction for future palliative care—a direction that Dr Clark spoke of at the forum—that palliation should begin at the time of diagnosis of chronic disease, not as people near the end of life. He said:
High quality care is less about buildings and structures and more about the involvement of people in decisions about their care. It is also about involving their primary carers in those decisions so that the need to transfer to specialist services or clinicians becomes a safety net rather than a default model of care.
What is required is a commitment to advanced care planning—an ongoing, inclusive and open commitment to the involvement of patients or if they are unable, their nominated substitute decision maker, in all decisions, big or small, that need to be made to ensure high quality care right to the end of life.
So where to from here? We need to continue the process and have ongoing discussions to ensure we understand the community's wishes about how and where care ought be provided as people approach the end of life. We are currently surveying all people who attended the forum to determine if their needs were met, what their views are and their ongoing involvement and support.
World Hospice and Palliative Care Day takes place on the second Saturday of October every year and Voices for Hospices takes place on the same date every two years. This year World Hospice and Palliative Care Day will be on 13 October. In conjunction with the Friends of Northern Hospice and Palliative Care Foundation and Calvary Health Care, we intend to continue the education of the Launceston community and to continue raising awareness. We will also continue to lobby to have implemented the level of palliative care our community depends upon and deserves.
The other issue that I would like to discuss tonight is the 'Walk a day in the life of an aged care worker' campaign. I accepted an invitation from the Health and Community Services Union to participate in the campaign recently. The chosen venue was Fred French Masonic Home in Newstead. I was asked to do a range of activities that would routinely be undertaken by people working in an aged-care facility. Making beds, transporting patients, assisting with showering and helping to feed patients who were unable to feed themselves were among the activities I performed.
While it is easy to assume we understand what each job is about, it is not until you have firsthand experience that you start to realise the challenges that aged-care workers have to deal with routinely. There was no let-up during the time I was there—the staff were constantly on the move from one job to the next. Many of the activities were quite physically challenging and demanding. I recall one resident in particular who was quite adamant that he had never seen a politician work so hard before. I suggested to him that he should not be so cheeky since I was about to wash and dress him, but we did enjoy a chuckle. The demands of dealing with those residents who have even just a mild form of dementia are significant. It is extremely time consuming to have to keep reaffirming the answers to questions they have and to go through the daily routine with them.
I had first-hand experience of aged-care facilities through my experience with my mother. She spent almost three years in a high-dependency care facility. I was regularly there and saw, from that side, what the wonderful workers were able to do, even though they were very pressed for time. Their patience, their commitment and their dedication to their work were just so impressive. To actually work alongside them, to understand the paperwork and the responsibilities they have, was an eye-opener for me in many ways. It also helped me realise what a challenge it would be to be personally responsible for those residents on a day-to-day basis. I have the utmost respect for what they do in their work. Even though I did not have to interact with any of the family members during the brief time I was there, that is another dimension to the work of those in aged-care facilities. They have to have that ability to communicate with the families and to reassure them of what is happening with their loved ones.
I would encourage anyone in this chamber or in the other place, if they get the opportunity, to go and spend that time. I think you will find it very rewarding. I did remark to the staff during our discussions over a cup of tea that I was quite relieved to be able to go back to my office. I do think I am more suited to being a senator than an aged-care worker because I am not sure I would be able to develop the emotional detachment you would need to enable you to survive, because it would be natural to develop an attachment during the time you were caring for these individuals and you would need to be able to switch that off at the end of the working day. The lady I helped give breakfast to reminded me so much of my own mother. I found that very emotional but also very rewarding.