Regional Hospices

Wednesday June 28, 2023

Mr BELL (Mount Gambier) (11:12): I move:

That this house—

(a) recognises the need for varied end-of-life care in regional areas; and

(b) calls on the state government to investigate the potential for a dedicated palliative care facility based in the City of Mount Gambier and servicing the wider Limestone Coast region.

What is a good death? According to the Grattan Institute in their research paper Dying Well:

A good death meets the individual physical, psychological, social and spiritual needs of the dying person. Most people prefer to die comfortably at home or in a home-like environment with minimal pain and suffering. They hope to be surrounded by friends and family and the care services they need.

A good death means choice. Approximately 70 per cent of South Australians wish to die at home, yet only 15 per cent manage to do so, with a majority being in hospitals or residential care homes. Rising rates of cancer, chronic illnesses and other conditions such as dementia coupled with our ageing population have led to a rise in demand for palliative care services. Palliative care in Australian hospitals has increased by 28 per cent over the last four years. The impact of ageing and increased numbers of single-person households will continue to place a greater demand on health services.

Country patients have to do it tough. Those who suffer with cancer and chronic illnesses will have already had to spend countless hours travelling and days away from home to undertake treatment in Adelaide or Warrnambool. They do not have the luxury of returning to their home and family after treatment each day.

Currently, the Limestone Coast is serviced by a hardworking team of specialist palliative care nurses who cover an extensive area from Mount Gambier to Bordertown. They provide these services between 9am and 5pm Monday to Friday. Our local hospital has one dedicated but not exclusive palliative care room, which is situated in an environment that struggles to provide person-centred care that meets the holistic, cultural and spiritual needs of the patient and their loved ones. There is no resident palliative care specialist.

Recently, through the efforts of the chair, Maureen Klintberg, and a dedicated group of volunteers, we have seen the introduction of the Mount Gambier In Home Hospice Service. This service provides vital non-medical support and assistance to help ease the burden on carers and families, allowing patients to stay home and out of hospital for longer. Too often in regional areas we lack access to the same services our metropolitan counterparts enjoy.

Whilst we applaud the government's recent addition of an additional part-time specialist care nurse to the Limestone Coast, there is still much more to be done and many gaps that need to be filled. An example of this is 53-year-old Mount Gambier resident Glenys Smith and her sister Annette Smith. Glenys was diagnosed with breast cancer in 2015 and received a terminal diagnosis in December last year. She suffers from severe lymphoedema in her right arm, which has led to Glenys requiring round-the-clock care, as she requires assistance for general everyday tasks. Glenys was a carer for her mother, who now resides in an aged-care facility.

As Glenys now lives independently, her sister Annette has moved out of her own home she shares with her partner to help care for Glenys. Annette, who suffers herself from rheumatoid arthritis, has spent countless hours advocating on behalf of her sister and navigating the regional health services to find assistance for Glenys so that she can maintain her own employment. When Annette first called Carers SA, she was told it would be two weeks before anybody would be able to return her call.

She has been receiving assistance from the palliative care nurses and the volunteer In Home Hospice Service. Homecare Plus was visiting three days a week for a total of two weeks; however, the funding for this package was only available for a two-week period, as this was for end-of-life care. Annette then had to apply through Carers SA; however, limited funding meant this was now reduced to 3½ days for the next two-week period, leading to the constant stress and worry of what the next week would bring and who would care for Glenys.

Whilst we rightly speak about the patient's needs, we also must not forget about the carer's needs. The emotional and physical burden for those caring for loved ones can be great. Just two weeks ago, Annette reached the point of exhaustion and needed help. The only option available was to have Glenys admitted to the local acute hospital in Mount Gambier. Glenys has now undergone an ACAT assessment, and it has been assessed that her needs do qualify for respite care. ACAT stands for Aged Care Assessment Team; Glenys is 53.

The only option available is an aged-care facility. This then depends on availability, with patients often being sent to Millicent or Naracoorte, up to 100 kilometres away. Glenys has now found accommodation for respite in Mount Gambier; however, there is a wait for this to occur, and in the meantime she is still in the Mount Gambier hospital.

Another Mount Gambier resident, Fay Lamond, was unable to be placed locally. I became aware of Fay's story through the advocacy of her granddaughter Gail. In early 2020, Fay became unwell. At this time, she lived at the Woodlands retirement estate with her husband, Col, for whom she cared after he suffered a stroke in 2018. In March, it was discovered that Fay had bowel cancer and required surgery. This required Col to go into an aged-care facility. No beds were available locally, so he was transported to Sheoak Lodge in Millicent, which is 50 kilometres away.

After Fay's surgery, she needed to be transferred from the hospital to a respite facility. Again, there were no beds available in Mount Gambier. She, too, was transferred to Millicent but ended up in a different facility from her husband of 64 years, that is, Boneham Lodge. During this time, COVID arrived and Fay's family had to travel over 50 kilometres for a half-hour visit. At a time when Fay's family wanted to be by her side, Fay spent most of her days alone, with overworked aged-care workers and nurses trying their best in unprecedented circumstances.

Her last three weeks were spent in Mount Gambier hospital, the family restricted to 15-minute visits by no more than two family members at a time for two hours a day and her great-grandchildren unable to visit at all due to COVID restrictions. There was no designated palliative care room, and the family found themselves congregating in corridors in the clinical hospital environment with no place to go for a moment's reprieve other than the hospital cafe. Since the passing of her grandmother, Gail has become a passionate advocate for palliative care and fundraised for a cuddle bed, which is now being used in our local hospital. Too often, country residents are taken for granted and made to feel like we should be happy for what we have.

I am calling on the state government to investigate the potential for a dedicated palliative care facility to be based in Mount Gambier, the state's second largest city, and to service the nearly 70,000 residents in the Limestone Coast—a facility that provides a homelike environment for those who have a chronic life-limiting illness, a facility that provides respite for both patient and carer, a facility that can be a home to our specialist palliative care unit, a facility that can be home to our invaluable in-home hospice service, a facility that can give our student nurses and doctors the ability to specialise in palliative care, a facility that gives people a choice in their end-of-life journey. Let's give those who have been given an end-of-life prognosis the dignity of choice and give them a good death.