Palliative Care
Palliative care is for people who have conditions and illnesses that have been diagnosed as terminal, meaning they cannot recover from them.
Once an illness progresses to the stage when a loved one is close to dying, the focus of their care changes to palliative care and helping them to live as well, and as comfortably, as possible for the time they have left. Depending on their illness, this can take place in your own home with the help of medical professionals or in a hospice, hospital or care facility.
What is Hospice?
There are hospices all around New Zealand that provide palliative care to people in their local community. They take a lead role in someone’s care when there’s no longer a cure for the person’s illness. Palliative care is available for people with cancer and other diseases such as end-stage heart, respiratory and kidney disease, Alzheimer’s, AIDS, motor neurone disease (MND) and multiple sclerosis (MS).
In addition to the health professionals on staff, some hospitals also have a team of palliative care specialists who provide medical and nursing care to patients as well as advice and support to hospital staff, palliative patients and their families. Hospices offer specialist care specifically to people with a life limiting condition and their families/whānau. Most care is provided at home, with hospice staff visiting people on a regular basis and providing a wide range of support services.
Hospice principles of care
Hospice New Zealand follows principles of palliative care, which help to determine how people are cared for. They do their best to ensure that people: Live with minimal pain and that any pain is well managed (many people find strength in their suffering and don’t want to take drugs that might stop them communicating).
- Keep their dignity
- Have their decisions and choices respected
- Are treated with openness and honesty
- Are cared for with love and respect and without feeling they are a burden
- Die as they would wish (either alone or surrounded by loved ones)
- Die where they wish (either at home or somewhere else)
Go With Grace Podcast – Episode #9
Dr Warrick Jones: The Changing Face of Palliative Care in New Zealand
In this episode, Katy talks with Dr Warrick Jones, medical director at North Haven Hospice in Whangārei, about the past, present and future of palliative care in New Zealand.
Warrick’s mahi in palliative care began in his 20s, nurtured by strong community-based values growing up in Kaitaia in the Far North, and shaped by his own personal loss and a desire to always take a holistic approach to health and wellbeing.
We talk about how amazing the human body is at all stages in life, including dying. Warrick explains the changes in palliative care in New Zealand over the last 30 years, as well as the incredible people who are providing this care, and we imagine how palliative care could change for the better in the future.
What is home-based care?
Home-based care is a part of the programme of care hospices provide. It includes specialist nursing care and other support services such as day or respite care, for the carers of people who are dying. This means someone will take over for a while so you can go shopping or have a break. Alternatively your loved one could be admitted to the hospice inpatient facility to provide carers with a short break, as being a carer can be incredibly exhausting. The home-based team also coordinates referrals to another care setting when needed, for example, residential care.
People with acute needs can be cared for in the hospice inpatient facility instead of a hospital and once their condition is stable they go home again. Sometimes people go into a hospice because their carer needs a longer break than one day or they can’t look after them for short periods. Inpatient facility stays are usually short term and it is common for people to move in and out of the inpatient facilities several times, during their time. People may also choose to die in a hospice.
End of Life Doulas
End-of-life doulas are not a replacement for nurses, doctors or other healthcare professionals. They generally provide non-clinical support, while palliative care professionals are responsible for medical care, symptom management and clinical decision-making. A doula can work alongside your existing healthcare and palliative care team. Their role can complement clinical care by providing additional time, practical assistance, companionship and support for both the person who is dying and their family.
Palliative Care FAQ
Who pays for hospice care?
Hospices don’t charge for their services. Hospices are charitable organisations that get some funding from the Government through District Health Board contracts. The rest of the money they need comes from the community they serve through fundraising activities, grants, donations and bequests. Public hospitals provide palliative care without charge to patients. Private hospitals and residential care homes usually charge for the care they provide. G.P.s may charge for visits to patients with palliative care needs.
Can palliative care help family and whānau too?
Yes. Supporting family and whānau is an important part of palliative care. This may include practical information, emotional and spiritual support, help preparing for what to expect, and bereavement support.
How do I choose an end-of-life doula?
Ask about their training, experience, services, fees and scope of practice. Just as importantly, talk with them about their approach and whether they feel like the right fit for you and your whānau. It can also be helpful to ask how they work alongside hospice and other healthcare professionals.
How can I record the kind of health care I want?
Advanced care planning is a process of thinking and talking about your values and goals and what your preferences are for current and future health care. It helps you to understand what the future might hold, and say what health care you would or would not want, including end-of-life care. More on advanced care planning…
Is palliative care only for people who are dying?
No. Palliative care can begin much earlier in an illness and may be provided alongside treatments aimed at managing or treating the condition. You don’t need to be in the final days or weeks of life to benefit from it.
What can an end-of-life doula help with?
Depending on their training and scope of practice, a doula may help you talk through your end-of-life wishes, prepare an advance care plan, consider funeral or after-death wishes, create legacy projects, organise practical matters, provide companionship or respite for family caregivers, and help everyone feel more prepared for what may happen.