Professor Ken Hillman witnessed his elderly mum, Margaret, admitted to hospital 22 times in the last year of her life with a range of conditions.
His 83-year-old mum was frail due to her old age and had become vulnerable to infections after hip surgery.
It’s a familiar story faced by many Australian families as the population ages.
Speaking at a large medical gathering in Sydney, Hillman said on average a dying person in Australia will be admitted to hospital eight times in the last year of life and make two visits to the emergency department, while 60 to 70 per cent will die in hospital.
Historically, ‘grandfathers’ died at home, the hospital was where “poor” people died, said Hillman, an intensive care specialist at Sydney’s Liverpool Hospital.
He says it is a “myth” that hospitals are good places to die.
The evidence also shows it is largely a myth that doctors know how to diagnose dying well, he said.
“Hospitals are great places to get better and to be cured if that’s possible,” he told the Australian and New Zealand College of Anaesthetists (ANZCA) Annual Scientific Meeting and Royal Australian College of Surgeons (RACS) RACS Annual Scientific Congress in Sydney.
With one-third of all medical interventions in the last year of life deemed futile, anaesthetists and surgeons were on Tuesday asked to reflect on the role they play in end-of-life care.
Hillman said frailty should be one of the most important guides to determining whether surgical intervention is worthwhile.
“Age-related frailty is not curable,” he said.
ANZCA president Professor David Scott recognises the need for better education and communication in this area, which is why the college is promoting the development of a perioperative medicine qualification – which relates to all care before, during and after surgery.
The extra qualification would create an environment where the “difficult conversations” between doctors, patients and their loved ones could be had, said Scott.
“What we are facing is older sick patients with lots of things wrong with them and we need to address that to deliver the sort of care people expect and want, he said.
“We need to move from focusing on one disease or one operation to the whole patient,” added Scott.Do you have an idea for a story?
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