By Dr Umberto Russo MBBS, FRACGP
Working in the after hours, our Doctors are frequently called to the bedside of a person requiring palliative care or end-of-life care. Some of these patients may be in an aged care facility, while others are at home.
The aim of palliative care is to improve the quality of life for patients by preventing and relieving suffering, and providing support to their family and friends.
Quality care can be provided in the patient’s home where the patient can remain in familiar surroundings, rather than be moved to the unfamiliar setting of an Emergency Department or hospital ward. Ultimately though, palliative care can be provided where the patient and their family wants it, whether it be in the home, a residential aged care facility, hospice or hospital.
Palliative care at home
Often patients nearing the end of their life express a wish to remain at home. In this case carers and family should know that there are professional services available to help. For example, if medical care is required in the after hours, and the patient’s GP is not available, carers can become anxious and unsure of what to do. Often their first reaction is to send for an ambulance, however this may not be the best option.
A doctor home visit from 13SICK, National Home Doctor may be a better option.
Having a doctor home visit can also provide practical and emotional support and reassurance for carers and family members, alleviating some of the stress and anxiety associated with palliative care symptoms in a loved one.
13SICK Doctors also support aged care facilities across Australia, where staff and families are often faced with rapid deterioration of a resident in the after hours, or on weekends.
Training for our Doctors
As Doctors we understand the complexity of palliative care – both for patients and their carers. That’s why as part of our Continuous Development Program we hold sessions for Doctors in palliative care and the treatment for end-of-life patients in the after hours.
My colleague Dr Ben Forster, Medical Oncologist and Palliative Care Physician, is a lecturer and mentor to our Doctors in the field of palliative care. His advice to Doctors includes the importance of care for not only patients but also for carers too.
“The job of the Doctor in the palliative care situation is to alleviate and prevent suffering by attending to physical, emotional and spiritual concerns. The main focus is on the patient and supporting their caregivers, rather than disease-directed therapy. Having doctors skilled in the palliative approach who are able to attend to a patient at home can often prevent unnecessary hospitalisation and provide great comfort to patients and their families”, says Dr Forster.
13SICK is there for you
13SICK, National Home Doctor Service Doctor is well placed to respond to the medical needs of palliative patients in the after hours. Our Doctors are familiar with palliative care plans or directives. If the patient is suffering from a complex or chronic condition, their regular GP can send us ‘Special Patient Instructions’ which are stored on our system and accessed by the home visiting Doctor. Our Doctors follow these treatment instructions and keep the patient’s GP informed with clinical notes the following morning.
13SICK, National Home Doctors carry many medications which are useful for managing common symptoms seen with palliative care such as pain, vomiting, nausea, shortness of breath, noisy breathing, anxiety, sleep problems and agitation.
Comfort and support
For many of us, the subject of death and dying is an uncomfortable one, and we tend to avoid talking about it – until the day when a loved one requires palliative care or nears the end of their life. For families to cope with the challenges, they need to seek the help of professionals, including our 13SICK Doctor team.
If you are caring for a loved one in a palliative situation, or in the last days and hours of life, remember, 13SICK can help, with bulk billed doctor home visits on weeknights and weekends, when GP Practices are closed. Our role is provide the best possible palliative care – to both patients and their carers.
Dr Umberto Russo MBBS (Adelaide), FRACGP is Chief Medical Officer at 13SICK, National Home Doctor Service. He has more than 25 years' experience both as a General Practitioner and a visiting home doctor, with a special interest in urgent medical care.