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Hospice/Palliative Care

Removing barriers for a family member to die at home

Co-operation between providers of palliative care

Care provided in a hospice

Hospice think tank helps achieve resolution

 

 

 

 

 

 

 

Removing barriers for a family member to die at home

Palliative care ~ Rest home ~ Right 1 ~ Respect ~ Effective Communication ~ Right 6 ~ Rully informed

An older woman was receiving palliative care at a rest home. Her family felt their wish to have her at home to die was not being respected by the rest home manager. Following initial contact by the family, the advocate met with the consumer, who while very frail, was clear that she wanted to go home.  She asked the advocate to speak on her behalf at a meeting with the rest home manager and her family.

At the meeting the advocate was able to pass on the woman's wish to go home. The family expressed their concern that the rest home was putting obstacles in the way to prevent this from happening. The meeting provided a forum for the consumer's voice to be heard, her family's concerns to be addressed as well as a discussion on equipment that would be needed so that the consumer would be as comfortable as possible at home.

The consumer was transferred home by ambulance later that same day and spent two days at home, before dying peacefully with her family around. 

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Co-operation between providers of palliative care

A consumer receiving palliative care support from her local hospice for multiple health issues contacted an advocate for help to stay at home. She had been admitted to hospital when her health deteriorated but had got no response to requests for information about what support was available for her to stay in her own home. She requested advocacy support to meet with the NASC, Hospice and medical staff to discuss her concerns and get co-operation between the providers involved in her care.

As well as the lack of co-operation, her complaint highlighted:

  • Inadequate information about support services and equipment from the NASC including respite options and costs.
  • Lack of information about options for support in her current situation.

The consumer wanted sufficient information to make informed decisions about her ongoing care and was frustrated that her wishes to stay in her own home had been ignored by the Hospice and NASC, despite having the support of her family.

The advocate supported the consumer at the meeting. Her questions were answered and she was discharged from hospital to her own home with the appropriate support. The consumer was very happy with this outcome.

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Care provided in a hospice

A woman contacted advocacy following her husband's death in a hospice.  Her husband had been in considerable pain and the family had worked with the hospice to provide care which they were very happy about.

On one occasion, however, a nurse requested the family leave while she provided a bed bath for the man. When they heard him screaming they returned to see what was happening, but again the nurse requested they leave, which the family found very distressing.

Following the man's death, his wife lodged a complaint with the hospital about the care provided by the nurse. She was contacted by a manager and invited to meet to discuss her concerns. The complainant sought advocacy support, and prior to the meeting they discussed the meeting process, what the woman wanted as a result of the meeting and what support an advocate can provide. The woman was very clear that she was seeking an apology, and that she wanted the nurse to either receive further training or to be stopped from providing care in a hospice.

The manager acknowledged her concerns, provided an assurance that the nurse would receive further training and offered an apology. The consumer was happy with the outcome. 

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Hospice think tank helps achieve resolution

A woman whose husband had recently died at the local hospice after a long illness contacted an advocate about her concerns. She had kept an up-to-date journal recording her concerns about her husband's care. Despite the concerns, she made it clear that without exception all the hospice staff had been kind and caring.

Her concerns included:

  1. incorrect prescribing and delivery of medications on a number of occasions
  2. A lack of careful observation and basic nursing care
  3. A repeated failure to meet her husband's needs causing unnecessary and avoidable distress to them both

She had only contacted advocacy after receiving a poor response to her letter to the Hospice Manager. She felt they had failed to own the problem, had minimised her concerns and had not even reviewed their processes.

She wanted to be reassured that the problems she and her husband had encountered would not happen again.

During the period of working with advocacy and considering her options, the hospice rang to invite her to be part of a think tank meeting. They thanked her for being the catalyst in setting up this meeting which was to look at all their processes to see what could be improved. For this person it was a much-needed affirmation that her concerns were validated and her complaint had been heard.

Although the advocate, in this instance, did nothing more than speak with her on a number of occasions, the woman made it very clear that having someone on her side at a very difficult time had helped her have confidence in the complaint process as well as with grieving..

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