Aim
To develop a model that is holistic, patient-centered, flexible, sustainable, owned and developed by the local community (not imposed by others), tailored to meet community needs and offer home-based services.
To coordinate care that will facilitate the patients in returning home to spend their last days on country.
Outcomes
The framework supports the community to identify gaps and provides resources to assist communities to meet their needs. The model is flexible, sustainable, owned and developed by the local community (not imposed by others) and tailored to meet community needs. It also importantly increases the knowledge and skills base in palliative care for communities and clinicians.
A broad desire is both expressed and understood across all consultations that end-of-life patients wish to 'die on country'. The view was strongly expressed that end-of-life care outside community results in loss of identity that has unresolved ongoing impact on family and community wellbeing.
Background
While Palliative Care Services are a well-established model of care across Australia, within Torres and Cape communities the same results are not being achieved due to unique community needs, geography and healthcare settings. Specialist consultation can be delivered through the provision of Telehealth. However, specialist physical care can currently only be delivered in Cairns, resulting in patients not only having to travel long distances but also being removed from their normal support systems.
Quite often, poor access to palliative care services results in avoidable hospital transfers and travel, dislocation from community and associated stress for family members. Historically, there has been a poor understanding of cultural considerations related to death and dying within Torres Strait and Cape communities.
Furthermore, end of life care can be a sensitive topic within any community and a high level of community engagement and support is needed for patients to return to their remote communities for care.
