One Good Death

Creating An Improved End of Life Experience

Category: Research

Challenge

The Australian population is aging. In 2016, 15% (3.7 million) of Australians were aged 65 and older, by 2056, it is projected there will be 8.7 million older Australians (22% of the population). This strategic research project, which explores the relationship between GP’s and the management of the terminally ill and ultimately how the provision of services to the terminally ill could be improved, was undertaken in two phases. During the first phase research was undertaken that expanded upon pre-existing research provided by the client (name withheld for confidentiality), an aged care provider located in Melbourne. The second phase would focus on an element of an older person’s end of life journey as identified in the first phase, to provide insights to enable improvement in the aged care providers service. 

Results

The first phase identified that resistance to advice given by health care professionals had in some cases caused patient trajectories to gain negative momentum. This was encapsulated in the scenario where health care workers experienced resistance to the provision of services that may have extended an older person’s ability to live in their own home, an element that very much defined an older person’s sense of freedom. Research undertaken to gain these insights included, stakeholder interviews, journey, environment and stakeholder mapping.

The second phase sought to expand the knowledge of the General Practitioner (GP) – adult patient relationships, specifically relating to conversations instigated by the GP at the onset of a decline in patient wellbeing. Interviews with GP’s and patient representatives were undertaken using a participatory approach encouraging the creation of visual representations of their answers. GPs are able to and do provide high quality end-of-life care and allow more people to die at home. However, some patient’s needs fall outside of what a GP can provide, thus an opportunity was identified to improve end of life outcomes for older adults. Those who may have become isolated and do not have access to emotional support or those who need more time than is available to come to terms with the situation the GP is presenting were cohorts who might benefit from service improvement in the aged care providers provision.