Dying is not only a physiological event, but is relational and spiritual (L Sallnow 2022, Lancet 399:837-84). It is estimated that 75% of people who die of an anticipated death would have required palliative care support and expertise. Data from the Australian Institute of Health and Welfare (AIHW) estimate the average length of time a person receives palliative care support at the end-of-life is 15 days, which is considerably less than the recommended 3 months to enable a thorough holistic approach to the patient and their family’s needs. Most Australians still die in an acute care setting, and the recognition that an individual is dying is not formally recognised till the last 48 hours of their life. The medicalisation of dying has resulted in the community lacking in death literacy.
The complexity of providing palliative care has increased as a result of an aging population, rise in the number of people living with multiple chronic conditions and the evolution of oncology care resulting in people living with cancer longer but concurrently accompanied by complexity in their end-of-life care.
The challenges facing Specialist Palliative Care services in the next decade will be to ensure we have a workforce with the confidence and competence to care for people with complex needs at the end-of-life, people die in their preferred place of choice, dying is acknowledged earlier and attended to appropriately and a public health approach is utilised to demonstrate that there is value in an individual’s death.