The tough conversation we all need to have

No one wants to talk about dying. Why would we? I could not think of a more depressing conversation to have around a dinner table, or at a party, or over coffee, let alone with the people who mean the most to you in your life. 

However, more and more as a community and as a country, we want to talk about death and, more importantly, the process of dying. There is an increased focus on patient care, on maintaining people’s dignity and quality of life and of managing pain outside a clinical setting. 

The recent palliative care announcement, introducing more support for people passing through their final illnesses, and their families, is an important step towards making sure everyone has the support they need at this crucial time. 

The goal is to allow people to explore the options available to them and choose the best for them. For many people this will mean finding a way to live the remainder of their life at home, close to their loved ones. 

In Lithgow, many people take the option to move into hospital rather than dying at home. There are lots of reasons why people need to move into hospital at this stage, including the demands of regulating pain, or access to equipment that cannot be transported. 

The goal, promoted by the government in the weekend's announcement, is not to stop access to hospital for those who need it, but to take all possible measures to make sure that those who want to take up the option to die at home can do so, with the support they and their families require. 

It is a balance that can be found between the patient’s medical care and their wishes to end their lives in their own home. 

It can be as simple as making a hospital-style bed available to be moved into a person’s home so that they can use its posture functions for easier eating, sleeping and moving into an upright position. 

Effective and timely access to palliative care is a right for all Australians. It should not be tied to geographic proximity to a major centre, in terms of population or facilities. It needs to be structured so that people in outlying districts, remote from population centres, have the same access, support and services available to them as people in the heart of town. As difficult as these conversations are to get started, they are important. They require planning, will and a big investment for effective implementation. 

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