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Compassionate and supportive to the end

Every day our staff do everything they can to save lives, but sometimes there is nothing more they can do, except provide compassionate, end of life care to patients and their families.

Earlier this year, Dr Harmeen Kaur, a medical intern at Peninsula Health provided end of life care to a patient in hospital for the first time.

“I was called to review a patient, and as soon as I walked in the door I couldn’t believe my eyes,” recalls Harmeen. “

We were ready for this man to go home but now he was drowsy and struggling to breathe. I knew he had end-stage lung disease and an infection but surely, we thought, he should be getting better by now.”

After recognising the deterioration, Harmeen escalated the case to the senior medical team. Together, they spoke to the man’s wife and daughter and explained that he was unlikely to improve.

“We asked them whether they had talked about end-of-life decisions as a family; whether they knew his wishes,” says Harmeen.

“Their response was quite immediate – he wouldn’t want any heroic measures but he would want to die peacefully in his own bed.”

Dr Anmol Bassi, a senior doctor at Frankston Hospital, says it is important to have open and honest conversations with patients and their family.

“If you are convinced that it’s an irretrievable situation, then you have to explain to the family why the patient should not be resuscitated and what the quality of life would be,” says Anmol.

“Sometimes we call in a palliative care consultant to help have these conversations with families.”

Dr Sandeep Bhagat, Head of Palliative Care, says he gives patients and their family the opportunity to say what they want to say.

“I give patients the chance to explain what has been happening in the last month, the last week and then ask what they think. In their own words they say: ‘doc I’m dying’,” says Sandeep.

 “Once we recognise dying we can focus on the patient’s comfort, their wishes and allow the family to have that precious time together.”

After having these conversations, Harmeen and the team made sure their patient was as comfortable as possible. He passed away later that day surrounded by his family.

This article was first published in Quality Care 2017. Read the full edition here.