5. Introduction
Introduction
People with a life-limiting illness want choice in when, where and how their palliative care is provided. They also want support to make choices about their place of death and assurance that their families, carers and loved ones are supported.
A priority for Queensland Health is to ensure that all Queenslanders have access to high-quality palliative care and support at the end of life. The Strategy aims to strengthen the healthcare system to ensure this care is culturally safe person-centred, equitable and accessible to everyone, regardless of where they live.
When developing the Strategy, we heard directly from Queenslanders through extensive consultation processes about what is needed to improve palliative and end-of-life care across the state. The feedback we received has directly informed the vision, principles, goals and actions outlined in the Strategy.
The Strategy is focused on Queensland Health, but all services across the state are encouraged to use the principles within the Strategy to guide their services. All Queenslanders have a right to a good death that is free from suffering, with the support of high-quality palliative and end-of-life care services. We know that a collaborative effort is needed to deliver this care and improve the palliative care system over time, and the Strategy reflects this need.
Defining palliative and end-of-life care
Palliative care and end-of-life care can improve quality of life and promote wellness for people living with a life-limiting illness, their families, and carers. Often, people associate palliative or end-of-life care with cancer, however, this care is appropriate for anyone living with a life-limiting illness, other chronic conditions, dementia, and non-malignant degenerative diseases.
Palliative care and end-of-life care may be required at any age, and the needs of children and younger people, their families and carers need to be considered. Considering people’s cultural needs and ensuring culturally safe practices for everyone receiving care is also important. For First Nations peoples, the time before and after death, which may be referred to as Sad News and/or Sorry Business, are subject to customary practices and beliefs, which should be respected and accommodated during the palliative and end-of-life care journey. This Strategy responds to the diverse needs of Queenslanders and aims to ensure people receive compassionate palliative care and end-of-life care that is respectful of their cultural, spiritual, emotional, and physical needs and preferences.
This Strategy affirms that palliative care is a person-centred approach, which is consistent with the World Health Organization definition used in the National Palliative Care Strategy 2018. People with a life-limiting illness should be at the heart of their care, surrounded by their family, carers, community and supported by services, which may include one or more of a range of formal and informal supports.
When we refer to palliative care and end-of-life care in this Strategy, we mean:
Palliative care
Palliative care is an approach that improves the quality of life of patients (adults and children) and their families who are living with a life-limiting illness, through the prevention and relief of suffering by means of early identification and correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.
End-of-life care
End-of-life care includes physical, spiritual and psychosocial assessment, and care and treatment delivered by health professionals and ancillary staff. It also includes support of families and carers, and care of the patient’s body after their death. Voluntary assisted dying is another end-of-life option for people who meet strict eligibility criteria. People are ‘approaching the end of life’ when they are likely to die within the next 12 months. This includes people whose death is imminent (expected within a few hours or days) and those with:
* advanced, progressive, incurable conditions
* general frailty and co-existing conditions that mean that they are expected to die within 12 months
* existing conditions, if they are at risk of dying from a sudden acute crisis in their condition
* life-threatening acute conditions caused by sudden catastrophic events.
We recognise that social and emotional wellbeing is the foundation for physical and mental health, including for First Nations peoples. This Strategy also adopts a holistic view for palliative and end-of-life care. This includes supporting relationships between individuals, family, kin and community while providing care, and recognising the importance of connection to land, culture, spirituality and ancestry, and how these affect an individual.