RE: PROPOSED Southern Highlands Hospice - I write to you as a local general practitioner and general practice visiting medical officer [VMO] at Bowral Hospital for 20 years or so.
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We have an excellent palliative care unit here headed by Mira Glavan with many nurses to look after people in their homes.
They are backed by two excellent palliative care consultant doctors. They work with the patient's GPs to provide end of life care.
They also can provide equipment to help in this such as hospital beds, oxygen machines, bedpans, lifting machines, etc.
They can look after the patient helping with blanket baths, showers and personal hygiene.
At the end of life people often need medication provided through syringe drivers, which deliver the drugs through a needle placed under the skin and constantly with a small electric motor pushing the syringe.
The syringe needs refilling every 24 hours or so and this is done by the nurses.
The nurses cannot provide 24-hour care at home but will visit at least daily as necessary.
Most people require 24-hour care in the last few days of life. Some families are able to provide for this for their loved ones and this is terrific when they can.
In the last few days some patients have to be admitted to hospital to get this full nursing care.
Frequently they are in a ward as the only patient so the family may stay as they want.
Over the years as a GP VMO, I have been involved in this care and often only meet the patient at this stage of their life, which may be for only three-to-four days. I believe this works well.
However it would be even better if the patient could stay in their own home to get this full end-of-life nursing care, which unfortunately can't be funded by State Health.
The Southern Highlands Community Hospice has done a great job raising money - I believe it's up to $1.7 million and I admire all the volunteers for working so hard in their five shops.
I think that rather than using all this money for real estate, could it not be changed to Hospice-in-the Home to fund nursing staff to look after people in their final days at home?
I believe that this could be available for people living in bed-sitters to mansions in the area. Also, people do not make appointments to die so there can easily be three-to-four people one week and none the next.
I think that what would be needed is one-to-two co-ordinators, possibly with an office (although someone's home might be suitable) and mobile phones, and they could co-ordinate a pool of nurses who would be employed on a casual basis as necessary.
For myself, both my mother and grandfather died at home and I would hope to do the same, rather than be carted off to some state of the art new building which is still strange to one.
I would ask the Committee of SHCH to consider this option of Hospice-in-the-Home seriously.
- Clive Cawthorne
