Support people to receive care and die in their preferred place
Supporting people to receive care and die in their preferred place requires consistent open communication, health literate information, and access to relevant services and equipment. Consideration of the care setting and whether the clinical needs of the person can be met should interface with systems to prevent or minimise unnecessary hospital admissions. If home is the preferred care setting, consideration of availability of community health and support services to meet the person and their family and carer’s needs is important.
Processes are in place for identified and embedded local pathways which support people to:
Regular assessment of the appropriateness of the preferred setting is also encouraged.
Assessment of needs and planning for place of death is important in respecting the wishes of the person with life-limiting illness, their family and carers.
Assessment of the person’s needs, preferences and values; family and carer capacity to provide care; and availability of an appropriate and safe environment, services, resources and equipment to provide care should be undertaken.
Risk screening and assessment needs to be considered and issues addressed for any children or other vulnerable people living in the household.
Facilitate or refer to appropriate in-home support programs and ensure liaison with the person’s general practitioner or primary healthcare provider regarding their role and availability in after-hours care.
Aboriginal liaison officers or palliative care Aboriginal health workers may assist with enabling Aboriginal people to be supported to die on ‘Country’, where possible and if desired. Multicultural health workers can provide advice on cultural considerations and requirements, including burial timeframes.
Referrers should consider the questions and use the tools and information below when providing virtual palliative and end-of-life care. The below considerations assume that discussions surrounding preferred place of death have already taken place.
Inform the patient, their family or carer of the virtual care modalities available, and document their preferences. Based on availability and mutual agreement, this could include their ability and willingness to travel due to wellbeing, ease and cost of travel, personal and family commitments, spiritual needs, and available technology. More on consumer support.
If death is preferred to take place in the community, do the family and carers need more information about accessing virtual care and how it may support them and their loved one? Do they need equipment or support to allow the patient to remain at home?
If the patient is an inpatient, does the treating clinician need to escalate to external clinical teams, or contact the patient’s family or carers who are not present or able to travel to the facility? Does the family or carer need equipment or support to facilitate connecting virtually with the patient or treating clinician?
Will having access to virtual care allow the patient to remain at home nearing death (if this is the preferred option) as opposed to requiring transport to hospital? Do they need equipment or support to allow the patient to remain at home?
Does the patient, family or carer need support to navigate the virtual care platform? Consider the need for an additional clinician, family or carer to be available to support the patient. Provide virtual care education resources as required.
For more virtual care resources, see:
Funeral Guide: Aboriginal Funerals
Information on Aboriginal funeral traditions and etiquette.
Funeral Zone Ltd | Information | 2019
Accelerated transfer to die at home plan (adult)
A form for integrated discharge planning that begins when a patient expresses the wish to die in their home environment.
Clinical Excellence Commission | Clinical tool | 2012
A resource for carers to ensure supports are in place when a patient expresses a wish to go home to die.
Clinical Excellence Commission | Information | 2016
Last Days of Life Toolkit: When someone dies at home what should you do?
A resources for carers which explains what they should do when someone dies at home.
Clinical Excellence Commission | Information | 2016
Enable paramedics to provide individualised care to a patient who has a life-limiting illness, in their home or in a residential aged care facility.
NSW Ambulance | Clinical tool | 2019
Procedures at time of death in hospital
Information for health professionals to inform discussions with family and carers when a child dies in hospital.
The Royal Children's Hospital Melbourne | Information | 2021
A booklet to improve the effectiveness of Aboriginal and Torres Strait Islander people's journey through the system for those that are affected by palliative illnesses.
Hunter New England Local Health District | Information | 2019
The Core Palliative Care Medicines List for NSW Community Pharmacy
Recommendations for community pharmacies to stock the five injectable medicines most commonly required at end of life.
NSW Ministry of Health | Information | 2019
Information for health professionals to inform discussions with family and carers regarding what happens when someone dies at home.
CareSearch | Information | 2020