Legionnaires’ disease alert for Sydney CBD. NSW Health

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PALLIATIVE CARE

Palliative care is person and family-centred care that improves the quality of life of patients and their families facing the challenges associated with life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.  

Palliative care is not the same as end-of-life care. You can receive palliative care at any stage of your illness. You can also continue treatment for your illness while you are having palliative care.   

End-of-life care is the care and services given to people and their families who are facing the end of their life, normally in their final weeks or months of life. End-of-life care is an important part of palliative care. 

Accessing palliative care

Palliative care is available to people of any age who have been told that they have an serious illness that cannot be cured, and that they are likely to die from.  

Palliative care assists people with illnesses such as cancer, motor neurone disease and end-stage kidney or lung disease to manage symptoms and improve quality of life. 

For some people, palliative care may be beneficial from the time of diagnosis with a serious life-limiting illness. Palliative care can be given alongside treatments given by other doctors. 

Where possible, palliative care is provided where the person and their family wants. This may include: 

  • At home 
  • In hospital 
  • In a hospice or palliative care unit 
  • In a residential aged care facility 

New MBS Level E Consultation (60 minutes or more)

New MBS Level E Consultation items were established on 1 November 2023 for longer consultations of 60 minutes or more where clinically required, as announced in the 2023-24 Budget. This will allow better management of care of patients with chronic conditions and complex care needs such as, but not limited to, patients with multiple chronic conditions, patients in need of advanced care planning, palliative care and end of life care.

For MBS items for General Practitioners for Patients in Residential Aged Care click here or for MBS items for General Practitioners for Patients in Primary Health Care click here

ADVANCE CARE PLANNING

Steps involved in advance care planning

  1. Incorporate advance care planning into routine care of patients during an ordinary consultation or as part of a health assessment.
  2. Assess capacity of patient to appoint a representative and complete an Advance Care Plan/Directive. 
  3. Witness or complete instructional directives where appropriate.
  4. Apply the patient’s wishes to medical care. 
  5. Review the plan regularly or when the patient’s health status changes significantly.

Assessing a patient’s capacity

Generally, when a person has capacity to make a particular decision they can: 

  • Understand the facts and the choices involved.
  • Weigh up the consequences, and communicate the decision. 

Enduring Guardian vs Power of Attorney 

If a patient does not have capacity to make decisions on their own behalf, an Enduring Guardian or Power of Attorney may be appointed.

The main distinction between an Enduring Power of Attorney and Enduring Guardian is regarding the matters about which they are permitted to make decisions in the event that a person loses capacity. 

The appointment of an Enduring Power of Attorney formally gives another person, or persons, the authority to manage a person’s legal and financial affairs. Depending on what the person directs, this may include buying and selling assets, operating bank accounts, and spending money on their behalf. 

The appointment of an Enduring Guardian gives another person, or persons, the authority to make lifestyle and medical decisions on a person’s behalf. These decisions may, for example, concern the person’s place of residence, access to medical care and providing consent for the refusal of medical treatment. 

Useful resources to support patients with advance care planning

The Royal Australian College of General Practitioners has guidelines on Advance Care Planning

The SPICT™ tool (Supportive and Palliative Care Indicators Tool) helps identify people with deteriorating health due to advanced conditions or a serious illness, and prompts holistic assessment and future care planning. 

Dementia Australia has developed the Start2Talk resources to assist with advance care planning. 

The Australian Government Department of Health and Aged Care provides an overview of advance care planning, including how to upload an Advance Care Directive to My Health Record. 

This NSW Health Information Booklet provides information to help you complete an Advance Care Directive. An Advance Care Directive form is provided at the end of the booklet, for you to complete and tear off. 

COMMUNITY PALLIATIVE CARE

South Eastern Sydney Local Health District: Prince of Wales Community Supportive Care Clinic,

St. George Community Supportive Care Clinic

Sydney Local Health District: Sydney District Nursing

Support for carers

Carer Gateway

Carers NSW 

Carer Help 

CURRENT PROJECTS

Greater Choice for At Home Palliative Care

The Greater Choice for At Home Palliative Care program, delivered through Primary Health Networks (PHNs), aims to design and implement innovative and locally appropriate initiatives that improve access to safe, quality palliative care at home. 

CESPHN initiatives include:

  • CPD events for health practitioners 
  • Education for home care and aged care workers 
  • Education for practice nurses and nurses working in residential aged care facilities
  • Development of a palliative care consumer resource
  • Upcoming viewings of the film ‘Live the Life You Please’ a social impact campaign that will change the way you think about the last chapter of life

Voluntary assisted dying

  • HealthPathways
  • CPD events