Dying let down by health system: report

Researchers say chronically ill Australians lack the support they need as their condition worsens. Source: AAP

CHRONICALLY ill Australians are being let down as they near the end of their life, according to an article in the Medical Journal of Australia.

Chronic disease accounts for more than half of Australian deaths but scant attention is paid to the support a patient needs as their condition slowly deteriorates, says the article.

Senior Adelaide University lecturer Teresa Burgess and her co-authors say the palliative care system was developed to help people dying of cancer over a relatively short period.

However, chronic diseases tend to follow a much slower process and are less predictable.

There is a "a progressive functional decline, poor quality of life and increasing dependency on both formal and informal caregivers as well as the health system".

The authors favour a patient-centred approach based on actual needs and symptoms rather than a prognosis.

They also want increased funding, better leadership and the use of palliative care specialists in end-of-life education and support.

Currently health workers assume a referral to palliative care providers will lead to the most appropriate care for people dying with a chronic disease.

"However, often this process is poorly handled, and GPs and primary-care clinicians are left to manage an unco-ordinated and challenging situation," the article says.

The result is patients too often receive inadequate care and die in an intensive care unit rather than in a preferred place of death.

"There is little opportunity for patients and their families to discuss issues around death and dying, and increasing stress on staff who are not trained in the provision of palliative care," say the authors.

"Using the term end-of-life care rather than palliative care could help to change health professionals' attitudes to the skills and training they require."

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