Providing more options at end of life

11 June 2024

The Comfort Care Centre concept bridges a gap in delivering excellence in end of life care. It offers older people another option and ensures at this most important time of their life, they are supported in a homelike environment, that not only cares for physical wellbeing but also nurtures spiritual wellbeing.

The Comfort Care Centre will provide palliative support for people in their last months of life. A comfort care service aims to provide what matters most to people when dying:
• a place to feel safe and heard.
• a place to reflect on their life.
• a place to be with their loved ones.
• a place where they are honoured.

The service will see VMCH working in conjunction with the community and in partnership with Cabrini Health to support people and their family to feel less burdened, so they can have a natural and loving experience. It will reduce the need for emergency department presentations and deaths during transfers to and from services.

It will provide a real option for people to die with dignity outside of the view that this is only available through ‘Voluntary Assisted Dying’.

Those who are diagnosed with a terminal illness and must experience their final months negotiating physical illness and the burdens of family care may believe the best option is to exercise the recently legalised Voluntary Assisted Dying. Opting for Palliative Care support at end of life has for the most part not been presented as a viable option in this discussion. VMCH is committed to developing services to demonstrate the exceptional outcomes for people and their families to experience end of life, peacefully and comfortably using palliative care services.

In support of this commitment, VMCH has been working to increase our capacity to deliver quality palliative care. We recognise the push for admission to residential care of people who are actively dying. Older people are often within weeks of death and their need for palliative care is not recognised at admission. They are often moved from acute settings into residential aged care or back to the community where their needs for end of life care are not met.

In 2017, Palliative Care Victoria (PCV) estimated that every year around 10,000 Victorians die without adequate access to palliative care

It is statistically known that 30 per cent of people who enter residential aged care will die within the first six months. Therefore 30 per cent of all admissions are for palliative care. There are also many older people (19 %), who are actively dying when they commence the admission process into aged care and die within three months without the necessary planning or preparation for death.

A Comfort Care service will meet a tragic gap in the current health system that impedes people, especially older people, from experiencing a planned and supported death without the concerns of being a burden to family or society.

According to PCV, the Victorian Government has provided funding for ‘Voluntary Assisted Dying’ but not the same resources to build options for quality palliative care. Our Comfort Care model does this (although at this time on a small scale); it provides the opportunity to demonstrate a new option to the community.

Dying is a natural part of life and human experience, not just a biological or medical event. People must be empowered to direct their own care, whenever possible. A person’s needs, goals and wishes at the end of life may change. We will provide a coordinated model of care that includes advanced care planning which carefully considers the wishes of the person and their family.

The goal of Comfort Care is to achieve the best quality of remaining life.

Staff will be able to manage symptoms that are causing discomfort or stress to the person or families and will be able to provide treatment to alleviate these. It is important that this is not a medical model and acute care will not be available; this may mean that some people who require ongoing acute care and are not stable during death will need to remain in hospital.

Providing for the cultural, spiritual and psychosocial needs of people and their families and carers is as important as meeting their physical needs. A dedicated pastoral care service will ensure a pastoral practitioner is available 7-days to offer spiritual care to residents and families. There will be an onsite Chapel and the service will require the support of the local priest or priests to conduct Mass and ensure that all Catholic rituals are available.

The physical environment has a profound effect on people’s quality of life. The importance of the surrounds and feelings of comfort has an enormous bearing on the person dying as well as on their family, friends and carers.

All spaces will be designed to be homely, relaxed and welcoming. All areas will be well lit, especially through natural light. The environment will provide for privacy as well as areas to support intimate family interactions, larger gatherings and sharing meals together. The design will incorporate good and easily accessible outdoor areas for residents to enjoy and spaces that create the opportunity for loved ones to be involved, to reminisce and create new memories.

Food and hospitality is a large component for families and the commercial kitchen will ensure residents and families are nourished. There will also be a domestic kitchen where families can cook their traditional favourites and share in the private dining space.

Bedrooms will be designed to enable families and friends to stay overnight, to sleep within the resident’s room or a dedicated family apartment.

This building will be a sanctuary for the person dying and their families and friends

VMCH is ready and able to take on this challenge. While there is still a long way to go in drawing attention to the importance of Palliative Care as a genuine option the at end of life, offering new services outside mainstream healthcare, is a step in the right direction.

Providing more options at end of life