Palliative Care in New Zealand

In 2015, New Zealand’s palliative care was ranked third in the world by The Economist. This is a huge achievement, but the need for palliative care is going to increase in the future. Understanding future needs and improvements in the industry will help the country continue to provide support and quality of life to people at the end of their lives.

What Is Palliative Care?

The Ministry of Health says palliative care is “care for people of all ages with a life-limiting condition.” A life-limiting condition is one that has no cure and will result in the patient dying. But palliative care is not just for people who are nearing the end of their lives. Palliative care is also provided to people with conditions such as motor neurone disease which people live with for many years.

Support is also offered to family, caregivers and whānau, both during the patient’s illness and after death. The service aims to give dying people quality of life and can include counselling, massage and physical therapy, assessment of conditions and health care.

Palliative care is mainly offered by hospices but can also be provided by GPs, hospitals and residential care homes. Patients can also be referred to palliative care through a number of different channels. Palliative care is most often provided in the patient’s home, as most people want to stay in their homes at the end of their lives. Many go to hospices for respite care, offering a break for both patient and caregiver, before returning home.

An Increasing Need

Palliative care is offered to people of all ages with a life-limiting condition, but it’s the aging population that is increasing the demand for the service. The total deaths in New Zealand are projected to increase by almost 50 percent in the next 20 years, and the age that those deaths will occur is also increasing. The proportion of people aged over 85 who are dying will increase from 37 percent in 2016 to over 55 percent in 2038.

Additionally, researchers in palliative care have revised the list of conditions that might benefit from palliative care. This means that the proportion of New Zealand deaths amenable to palliative care has risen from 56.3 percent in 2011 to 79.4 percent in 2016. This reflects a growing understanding of the assistance palliative care can give to patients, family and caregivers.

These figures reflect the increasing demand for palliative care but not necessarily the capacity within New Zealand to offer this care.

Preparing for the Future

The government’s mission is to provide equitable, high-quality care to all people who need it. Other goals are improved service integration, community education and new funding models. The Ministry of Health sees this as a priority, since care is so effective at improving quality of life.

Globally, the palliative care industry is moving towards a person-centred, holistic model of care that nurtures the emotional, spiritual and social life of patients as well as the physical. This is aimed at helping make the last stage of their life positive, and providers are working to allow the patient to direct the types of care and support they want and need.

However, the government needs to make sure the resources are available to provide care to everyone who wants it. Those in the industry have already raised concerns about how few doctors are graduating with a palliative care specialisation, and the same can be said of palliative care nurses.

Another concern is that deaths in residential care will increase 80 percent by 2038. This will require palliative care to be integrated more carefully into aged-care homes to ensure this support is provided to residents. People in the industry are also calling for more government spending in the aged-care sector to fund further palliative care in homes.

The 2015 ranking shows that New Zealand is on the right track when it comes to palliative care. With a focus on training and educating the community, the country can continue to provide a culture of life while helping patients die with dignity.

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