Dying with dignity - Bupa helps bring palliative care home

Maxine was 67 when she died after a prolonged illness with lung cancer.

While her husband Phil misses her every day, he feels comforted knowing that she spent her final months recieving palliative care her own home, and that she could have a say in how she was cared for.

“We did discuss being at home quite early in the [palliative care] process and we decided then, that’s where she wanted it to be. She was happiest at home, she was most comfortable at home, so it was a no brainer for us,” he said.

But most people in palliative care aren’t given that option. Research suggests that while 70 per cent of Australians would choose to die at home, only 14 per cent actually do.

That’s why Bupa partnered with St Vincent’s Private Hospital Brisbane to create the Palliative Care Choices pilot program, giving patients at the end of their lifes in Brisbane the option to be cared for at home, if that’s what they wanted.

Maxine was one of 133 Bupa customers who participated in the program last year. 95 percent of participants who chose to die at home were able to do so.

Patients received personalised care at home including specialist medical and nursing care, overnight nursing assistance, and counselling and allied health services (like physiotherapy), if they needed it. It was funded by Bupa, with the service delivered by St Vincent’s Private Hospital Brisbane.

It was delivered over the last six to 12 months of the person’s life.

Maxine was in a lot of pain, as the cancer had metastasised to her spine. Over time, she lost all movement in her legs.

With the help of her specialist from St Vincent’s Private Hospital, Dr Rohan Vora, Maxine had an epidural line inserted into her spine with drugs administered through a pump to manage her pain, which she took home with her.

“It was an easy discussion for us to have, because the whole idea of this was to get Maxine comfortable and get her pain under control to keep her at home”, said Phil.

“She was much happier being at home than she would have been in hospital. They came every second day to top up drugs in her pump, until the last couple of weeks in Maxine’s life when they came in every day to help manage the pain.”

While home palliative care was the best decision for Maxine, Phil says it wouldn’t necessarily be the best decision for everyone. But the important thing was, they had a choice.

“It was a pretty tough job for me to nurse Maxine at home, but I was capable of doing it, I wanted to do it, so we did it.”

It also meant Phil could spend more precious time with his wife.

“I live on the north side of Brisbane so while she was in hospital I was only able to visit her for a few hours a day. I’d try to come in in the evenings to help her with dinner. But when she was at home, I was able to be with her all day every day.”

“I believe she probably survived quite a few months longer with the pump and the care she got at home. She just didn’t want to be in hospital.”

The program doesn’t just involve support for the person in palliative care, it also includes support for family and carers, before and after the death of their loved one.

Dr Paul Bates, Bupa Chief Medical Officer, said that improving end-of-life care gives people dignity, respect and choice.

“Conversations around dying still remains a taboo subject in Australia,” Dr Bates said.

The two-year pilot program will continue until August 2018.

“The results so far have shown that we can increase customer choice, improve quality of care, deliver high satisfaction for customers and families and suggests cost effective care that includes home care can be provided in the last months of life. It’s part of our commitment to giving people choice in the care they receive at the most sensitive times,” he said.

Maxine will be remembered as a devoted wife, mother and grandmother, who lived a happy and active life.

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