Aug 03, 2016

The Changing Patterns of Death and Dying in Australia

Unfortunately, according to the Grattan Institute, the reality for 54% of Australians is they die in hospitals. 32% die in residential care. Only 14% get their wish to die at home.

This makes dying in Australian more institutional than much of the rest of the world. People in the United States, New Zealand and France are more likely to die at home. In a hospital people are more likely to die while feeling lonely and disconnected. They are in an impersonal institutional situation. The staff and machinery give them lingering, sad deaths.

The situation continues to worsen because the baby boomer generation is now reaching 65 years old and beyond. Demographers predict the number of Australians dying every year will double over the next 25 years. That means the rate of deaths will increase a lot faster than the nation’s births.

People are now more likely to live into old age than to face a sudden, unexpected death at a young age through war, accident or communicable disease. They are more likely to know their end is approaching because they have a chronic disease, but the Australian medical system does not help them plan ahead to die at home.

Dying at home requires more than just supportive family and friends. It requires medical equipment, medicine and someone to administer palliative care. Instead, the elderly approaching the end of life face a confusing number of choices and interactions with medical professionals which do not lead to open planning for the end of life.

This is a major shift in the past 100 years. Partly it reflects how medical care in hospitals has improved. Years ago they were institutions where people went to die. That’s why the middle classes and the wealthy preferred to remain at home, served by doctors who still made house calls. You see that in movies made in the 1930s. In the aftermath of World War II hospitals became safer places to receive treatment.

However, that change in attitude resulted in hospital care even for people who do not suffer from treatable conditions, but from the end of life. In the 10 years ending in 2012, hospitalization rates for men over 85 years old increased 45% and by 35% for women in that age group.

Dying With Dignity

Ideally, given the choice, people want to die at home in a situation meeting their physical, social, personal and spiritual needs.

According to the surveys, only 19% of people would choose to die in a hospital and only 10% would choose a hospice. Only 1% would choose to die in a nursing home.

What is a Good Death?

The Grattan Institute report gives many characteristics of a good death, assuming someone does know death is approaching. For most elderly people these days, that is true because they are suffering from chronic, lingering diseases.

People wish to retain control over what happens with them. That includes their choice of location, whether it’s a hospital, hospice or at home. They wish their family and friends present. They wish emotional and spiritual support.

They deserve their dignity and their privacy, and yet need access to medical expertise and care. Their need medical control of pain and other symptoms. And a good death includes the right to hospice care even if the patient is in a hospital or at home.

They have the right to control who is present at the end.

More Australians Could Experience a Dignified Death at Home

Out of the entire $100 billion healthcare budget in Australia, only $100 million goes for helping people die at home. As more baby boomers see death approaching, they and their families will begin pressuring for a shift in budget priorities. Money could be shifted from funding death in hospitals to helping people meet their end at home, changing the patterns of death and dying in Australia.

We are very keen to hear your views on this topic. Especially experiences you may have had personally or professionally as a palliative care nurse, doctor or carer that supports people when they are dying.

Leave a Reply

Your email address will not be published. Required fields are marked *

Advertisement
Advertisement
Advertisement

What Carers Should Know Regarding Constipation in the Elderly

Constipation in the Elderly Nearly everyone becomes constipated at one time or another, but the elderly are sometimes more likely than younger people. When you are a family carer, you may worry when there are no bowel movements every day but just remember that everyone is different. Being regular varies from person to person and... Read More

76% of aged care residents suffer constipation, study finds

  Constipation is the most common ailment among aged care residents, and it could be in part because providers are spending less on fresh food, researchers say. Researchers Dr Kimberly Lind and Dr Magda Raban, from Macquarie’s Australian Institute of Health Innovation, said the finding that constipation had the highest prevalence of all conditions studied... Read More

Residents “freezing” as heating turned off in aged care home

As the weather turns cold, a Victorian aged care home has been criticised for turning off its heating system after a resident contracted COVID. Residents were left in “freezing” bedrooms, and offered an extra blanket as temperatures dropped. This worrying incident led HelloCare to investigate: do air circulation systems need to be turned off during COVID outbreaks? Read More
Advertisement