Rural end-of-life care in New Zealand, Australia and South East Asia

Rod MacLeodDepartment of General Practice and

Primary Health CareUniversity of Auckland and

North Shore Hospice, Takapunard.macleod@auckland.ac.nz

The overall trends – not really different ‘down under’ An aging population Increasing life expectancy Rising numbers of the oldest old [Growing burden of non-communicable disease] Changing family structure Shifting patterns of work and retirement Evolving social insurance systems

Department of State and the Department of Health and Human Services. 2007. Why Population Aging Matters: A Global Perspective . Washington DC: National Institutes of Health

Michael Wright with Ednin Hamzah, Temsak Phungrassami and Agnes Bausa-Claudio

Oxford University Press

Hospice and Palliative Care in Southeast Asia

Australia McNamara B, Rosenwax L Factors affecting place of death in

Western Australia Health & Place 2007; 356-367

Almost half of Western Australians died in hospital

With increasing age there is a tendency to die in your place of residence

People accessing specialist palliative care had a seven times higher chance of dying in their usual place of residence

Australia 26,882 people died in WA in 2.5 year study

48.6% died in hospital 35.8% died in place of residence (private 20.2%; RAC 15.6%) 5.5% died in hospice 6.3% died in some ‘other’ place

McNamara B, Rosenwax L. Factors affecting place of death in Western Australia. Health & Place 2007; 356-367

Hospice care in NZPlace of death

Residential aged care

Home Hospital Hospice Total

2009 1390 (20%)

2261 (33%)

1363 (20%)

1792 (26%)

6916

2008 1926 (24%)

3852 (46%)

1207 (15%)

2044 (25%)

8150

2007 1079 (17%)

2744 (43%)

905 (14%)

1573 (25%)

6301

Procare project resources Palliative care Folder

Online resources (ProTube)

Hospice 24 hour telephone support Social workers Counsellors Chaplain Respite Care Symptom management Volunteers Day group programmes …. and many

more

Community Health Coordinators (ProCare)