Making a difference: Michael’s PhD research in end-of-life care and dementia has important implications on the palliative care sector. Michael’s research shows the relationship between the processes of decision making and identity creation. Both these processes are contributed to by persons with dementia, regardless of the stage of their illness, and those around them. Additionally, Michael’s research and social media expertise allow him to reach a wide variety of people in the sector and the community, giving him the opportunity to raise awareness of palliative care and highlight important issues.

• Provides an innovative approach to furthering our understanding of the social relationship between experience of Alzheimer’s disease and decision making.
• Involved with a wide range of research
• Recognised mentor within the palliative care community
• Actively promotes the practice of palliative care through online and social media channels

Making a difference: Oncology Massage (OM) Ltd aims to promote the integration of massage therapy in palliative care, through awareness raising and a nationally standardised program of training across Australia and New Zealand.

Qualified massage therapists and health professionals work safely with patients living with serious illnesses to reduce pain, anxiety and nausea.

Making a difference: Clare Holland House has introduced technology, clinical records and Wi-Fi to ensure that patients receive care at the right place and at the right time.  

• Introduced Palcare, an electronic clinical record which allows one continuous clinical record and real-time documentation of patient needs and care plans
• Introduced Medchart, an electronic medication chart
• Nurse Practitioner and Medical Outpatient Clinics to assess community care patients, allowing them to maintain their independence as long as possible and still receive support
• Emergency medication kit developed for home based palliative care team enabling them to treat emergent symptoms once a medical order is received

Making a difference: The Great Lake Hospice uses the interest from the sale of a cottage along with ongoing fundraising to provide financial assistance to cover the unforeseen costs of patients and carers.

• Great Lake Hospice supports patients’ costs of personal care, domestic assistance, equipment and medications
• The teamwork between palliative care workers and private service providers has allowed many patients to remain at home until death

Making a difference: Bear Cottage Children’s Hospice provides end-of-life care and respite for children with life-limiting illnesses and their families. Bear Cottage champions take an innovative approach to family support programs and team work.

• Bear Cottage Family Support team offer innovative inhouse and external camps including Junior and Senior Sibling Camps and Days, Mum’s and Dad’s Camp, BootCamp and Bereaved Family Camps. All camps aim to have fun, develop new skills, improve self-esteem, foster friendships and peer support as well as provide respite, grief and bereavement support.
• Feedback from the BootCamp, a six-month wellness program for mothers developed by specialists in the field of diet, nutrition, exercise and emotional wellbeing, shows that at least two-thirds of participants have improved their moods, fostered long lasting relationships with other mothers and have increased fitness levels
• Evaluation feedback from participants, volunteers and staff is valued and incorporated into all our initiatives.
• Our dedicated team of staff and volunteers are valued, support each other and share experiences that enable child and family focused care.

Making a difference: The Palliative Care Home Support Program is a NSW Ministry of Health funded initiative, providing patients with greater choice to die at home by topping-up the education of community care workers and evaluating service quality outcomes.

• Packages administered by HammondCare provide practical, in-home assistance with personal care and domestic support, and allow more patients to fulfil their wish to remain at home for as long as possible
• More than 400 care workers are now available across NSW providing coverage for 177 towns, plus full coverage across three metropolitan LHDs
• As part of the program, an extensive educational website has been developed, containing up-to-date information about palliative care for health professionals and the broader community.

Making a difference: Hall & Prior Menaville Aged Care Home has set up multiple methods to ensure that the passing of patients is respectfully shared with residents, visitors and Menaville community members, in order to show commitment and share grief.

• A photo of the deceased is placed into the Menaville home display cabinet
• A sympathy card is sent to relatives
• A staff member attends residents’ funerals
• Remembrance Services are held twice yearly (in June & December) for past residents

Making a Difference: The palliative care team at Calvary Mater Newcastle (CMN) partnered with Hunter Equipment Services (HES) to create a shared loan pool of basic and specialised equipment onsite at the CMN, in order to support the unique needs of palliative care patients, their families and carers to optimise their experience of end-of-life care in the home.

• Availability of basic equipment items for loan to patients in their home has increased from 52 percent to 100 percent.
• HES supplies and maintains basic equipment allowing CMN to purchase specialised equipment
• The loan pool has improved productivity, reduced waste and increased revenue
• There is more flexible in-home care
• New partnerships in the New South Wales regions between services delivering palliative care

Read the media release here: Helping dying patients made easier

Making a difference: Annmarie’s research found that one-in-five palliative care inpatients had a delirium diagnosis, while evidence-based guidelines for delirium exclude palliative care populations. This resulted in under-recognition and incomplete assessment of delirium in this patient group. Her research aims to improve outcomes for these patients.

• Her experience as a palliative care nurse has shown her the challenges patients and their families face when experiencing delirium
• Her research aims to find identifiable objectives to target and reduce the impact of delirium for inpatient palliative care patients.
• Now that she has submitted her PhD, Annmarie plans to develop and test a non-pharmacological delirium intervention designed to reduce the impact of delirium for inpatient palliative care patients

Making a difference: The Maitland Hospital’s Virtual Hospice offers an integrated system of tools, journals and learning experiences to deliver hospice-style care to patients, carers, health care professionals and local communities.

• Virtual Hospice teaches about comfort, safety, hospitality, resilience and self-care
• SPECTROMAN, a visual learning construct, symptoms and their management to all health professionals
• Experimental learning programmes (VISA and HEARTH) are tailored to specific staff groups in hospital and aged care facilities
• A hospital Comfort Care Plan has seen a 72 per cent confidence increase in discussing end-of-life care with a medical officer

Making a difference: Recognising the needs of Aboriginal and Torres Strait Islander people as they approach end-of-life, particularly the desire to die ‘on country’. The team contributes to better care outcomes for patients.

• Liaises with remote clinics, as well as a range of other service providers to ensure patients are on traditional land when they die
• Working to overcome barriers of remoteness, culture and language, along with high staff turnover in nurses
• Uses ‘Telehealth’ to connect health staff with patients
• Provides education and support to remote staff and health providers
• Ongoing liaison with oncology and chronic disease teams for patients across the remote service area.

Making a difference: Andre’s passion for education and further study in the palliative care sector has encouraged others to expand on their knowledge in the palliative care field. She is the primary trainer for Respecting Patient Choices education and has been responsible for several initiatives at Parkview to further staff development.

• Andre introduces end-of-life conversations
• Andre is the Primary trainer for Respecting Patient Choices education and trains staff to have the difficult conversations
• Her work has added to patient and family comfort by creating and designing timber trolleys which contain readings, refreshments, CDs and DVDs
• Andre initiated the Palliative Care Group which meets to discuss recent deaths and identifies areas for improvement
• Andre was honoured with Wesley Mission Brisbane’s 2014 Award for Compassion

Making a difference: Alzheimer’s Australia SA has developed an innovative program to improve palliative care outcomes for people dying from, or living with dementia. Despite being the second leading cause of death in Australia, dementia is rarely recognised as a terminal condition, resulting in many patients missing out on palliative care.

• Advocacy with the aged, acute and palliative care sectors to improve recognition of dementia as a terminal condition
• Build service and clinical pathways for people dying from dementia into palliative care services
• Capacity building to help health professionals recognise the terminal phase and provide dementia-specific palliative care
• Individual support and linkage to people dying from dementia and their loved ones

Making a difference: Palliverse is a multidisciplinary online community that aims to bring palliative care people, ideas and funding together by harnessing the power of the internet. Led by a dedicated team from across Australia and New Zealand, key projects to-date include:

• Blog (palliverse.com) generates and shares palliative care information, with has more than 13,000 views
• Various social media platforms broadcast and promote engagement (tweet chats, conference reporting, etc.)
• Palliverse peoples database connects people (clinicians, researchers, consumers, policymakers, etc.) with shared ideas and interests

Making a difference: Putting a focus on the needs of carers has led to the development of a number of tools and assessments that supports families and friends acting as carers, like the Palliative Care Carers toolkit.

• Assessment as part of continuous quality improvement practices
• Development of innovative practice improvements with the needs of carers in mind
• Created a standardised assessment of carer needs and developed a clear action plan to address their needs. This is also embedded in the electronic record management system.
• Developed and implemented an online toolkit for carers, available here: org.au/carer/toolkit.

In addition, Barwon Health use volunteers to supplement bereavement support offered to carers.

• Reviewed practices in response to the bereavement support standards for specialist palliative care services
• Due to volume of patients and workload, bereavement care was often not prioritised by nursing staff, despite the best of intentions
• To ensure improvement in bereavement care volunteers were trained and supported to provide calls to carers at 4-6 weeks post death and may pay a bereavement visit to the carer

Making a difference:  Fiona’s research in restorative care and patient outcomes resulted in the creation of the Maintenance and Independence Unit at her hospital. The unit aims to maintain functional status and improve independence for patients, as well as enable them to be admitted to the unit to reach their individual goals. She continues to advocate for restorative outcomes in other healthcare settings.

• Discharge planning starts at the beginning of the admission rather than a ‘wait and see’ approach
• Fiona has also completed a qualitative study examining rehabilitation models in palliative care units and the attitudes of clinicians who provide this care in Australia

Making a difference: “Social media breaks down barriers between patients and clinicians and is a great way to engage the community in a discussion about palliative care,” says Dr Elissa Campbell. Dr Campbell was recently nominated for the Inaugural Palliative Care Australia National emerging leader award.

Dr Campbell, a palliative care and geriatric medicine registrar in Western Australia, is using social media and a blog she helped create to spread the word about palliative care. Read more here:  Social media – breaking down palliative care barriers

Making a difference: The palliative care team at St John of God Hospital, Subiaco operate in a consultative model to provide and promote a patient-centred approach to patient care.
The team has developed hospital-wide strategies for appropriate and timely integration with palliative care which has resulted in increased referrals of up to 750 per year.

• Manages patients with advanced diseases both as inpatients and outpatients
• Works to ensure greater access to specialist palliative care for symptom management and supportive care
• Most patients referred to the service are receiving some form of life-prolonging treatment
• Nurses are trained in patient communication to develop skills for difficult conversations in response to patient distress