New research from Silverchain has found that people with complex health conditions are fulfilling their preference to die at home rather than in a hospital provided they have access to specialist community palliative care.
The study, published in the international journal BMJ Public Health, analysed outcomes of more than 4,100 people over six years. It found that those with non-cancer illnesses, such as heart or lung disease, often have more complicated medical needs yet are the most likely to achieve their wish of dying in their own home.
The findings come as palliative care-related hospitalisations in Australia have risen by 29% in recent years (2015 to 2022), a rate three times higher than all other hospital admissions.
With demand for palliative care services expected to double by 2050, the research highlights a critical solution to easing the mounting pressure on overstretched emergency departments and hospital wards.
The research challenges long held beliefs that specialist palliative care is best suited for those with a predictable decline. Instead, the research shows that people without cancer often enter palliative care with a high degree of health issues, more medications, and greater frailty, yet are still able to die in their preferred place supported by a community specialist palliative care team.
Silverchain’s National Director of Research & Evidence, and lead author of the study, Adj Prof Karen Smith OAM, said the study proves that a complex health diagnosis should not be a barrier to choosing to die at home.
“While 70 per cent of Australians say they would prefer to spend their final days at home, there is a lingering fear that complex medical needs make this impossible. This research turns that perception on its head,” Adj Prof Smith said.
“Traditional palliative care triage tools have been designed primarily for cancer patients. However, the increased complexity of non-cancer patients suggests more work is required to recognise palliative care needs in this cohort earlier and ensure equal access to specialist community palliative care.
“We are proving that medical complexity does not require a hospital bed. By bringing specialist expertise in the home, we aren’t just managing symptoms, we are safeguarding a person’s fundamental right to choose how and where they spend their final moments.
“It’s time our health system prioritised this choice for all Australians, regardless of their diagnosis,” Adj Prof Smith said.
The research findings contribute to growing evidence and calls for a national approach to specialist community palliative care as the number of Australians aged 85 and over potentially requiring palliative care is projected to double by 2042.
