We have delivered health care in this country in essentially the same manner for decades, which generally sees patients moved into care facilities, hospitals and hospices as they grow frail and end stage.

While we are fortunate enough to have one of the best health systems in the world, we must not become complacent and opposed to consumer-driven ways of delivering care.

In particular, we must constantly work to make sure we are delivering health care in the manner and place that is best for individuals.

People’s preferences change.

We can see this in the increasing desire Australians have to age in place, and now we know they want to extend this to being supported to die at home.

Seventy per cent of Australians would prefer to die at home, but only about 14 per cent of people do so. We want to see patient choice improved through increased support for in-home palliative care.

In Tasmania, a four-year hospice@HOME program has shown the significant benefits of giving people greater choice and control regarding their end-of- life journey. In-home palliative care not only enables people to stay in an environment where they are comfortable and with their family and friends, but offers significant health-care savings.

The Tasmanian experience shows that providing palliative care in a person’s home costs around $39 a day, yet a hospital bed costs $1500 a day.

Research suggests that about 30 per cent of health-care costs are attributed to the relatively small per cent of the population who sadly pass away each year (Banarto, McClellan, Kagy and Garber, 2004), and that the more we spend, the more we actually decrease a person’s quality of life in their final days.

It is time for us to investigate how we can enable trained health-care professionals to provide end-of- life care in a person’s home. 

Support must be provided so all Australians have the right to die in the place of their choosing.

Adjunct Professor Kylie Ward

CEO Australian College of Nursing