How can we die well? Aged and palliative care in Australian General Practice

One of the first concurrent sessions at this year's AGPN Forum discussed Real Health Solutions in Aged and Palliative Care.

Mr Keith Tracey-Patte (Department of Health & Ageing) opened the session outlining the Australian Government's National Palliative Care Program which is part of the National Palliative Care Strategy that was launched in 2000 and has received funding of $300 million to date. The aims of the program include increasing support for patients, families and carers and also the education and training of medical workforces. Dr Wayne Herdy, a GP in Nambour with a large number of residential aged care patients, explained the importance of having a living will (advance health directives, enduring medical power of attorney and guardianship) and the differences between each type. Dr Thomas Faunce (ANU) went one step further by suggesting that a medi-alert bracelet (or similar) be used to communicate that a living will was in place to avoid any disagreements over end of life treatment.

As a researcher, I was reminded just how important and demanding the role of a GP is, both in life and death. Ms Donna Daniell (Palliative Care Australia) asked how many GPs in the room had experienced the death of a patient in the last 30 days – a considerable number put up their hand. When asked to keep their hand up if this death was not a surprise, very few GPs lowered their hands. This illustrated Donna's point that when patients die, it's often not a surprise to the GP, so why is it a surprise to the family?

Communities can lose the experience of death and with it what is considered a normal or expected part of the journey. All presenters highlighted the importance of individuals determining what their minimum acceptable quality of life would be and having end of life discussions with family members and their GP before illness occurs so that each of us can die well in a setting of our choosing and without pain.