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Flinders move could "compromise" care for the dying

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The State Government’s planned replacement for the Daw House hospice would compromise care for the terminally ill, one of Australia’s most eminent palliative care experts says.

Emeritus Professor Ian Maddocks is a former director of Daw House, and was 2013 Senior Australian of the Year.

He told InDaily the fast-paced, acute medical philosophy of a hospital such as the Flinders Medical Centre could undermine the gentle, homely ethos of palliative care, currently provided at Daw House Hospice.

Daw House is on the site of the Repatriation General Hospital, which the Government intends to close as part of its ‘transforming health’ hospital reforms.

“(The proposed palliative care unit) may be swallowed up in the ethos of the hospital, and become much more hospitalised than … community-centred, and family-centred and looking at good, gentle care,” he said.

“The hospital has an ethos of acute care, busy care, lots of investigations, blood tests, x-rays … this sort of thing. Whereas, in palliative care, we are looking for gentle presence, not rushing things, being available, listening (and) talking with families.

“Daw House is pretty homely. For old people it was rather like home.

“I hope that they can reproduce that (at Flinders).

“(However) I’m worried that the whole ethos of the hospital surrounding it will compromise it quite badly.”

Last week, Health Minister Jack Snelling announced plans for a 15-bed palliative care unit on the fifth floor of a new, 55-bed rehabilitation unit to be constructed on the Flinders site.

The proposed development would replace the Repatriation General Hospital’s palliative care services and the bulk of its rehabilitation services.

“I’m disappointed, because it seems to me that it is giving a message about palliative care which is not entirely appropriate to the comprehensive care that I think dying people require,” said Maddocks.

He was worried that the volunteer program at Daw House, its complimentary therapies centre and research and teaching capabilities – along with the array of outreach services connected with it – would be lost or undermined by the new location.

“I’m a little bit frightened that some (of those) may be lost,” he said.

Flinders University Emeritus Professor Ian Maddocks.

Flinders University Emeritus Professor Ian Maddocks.

“There is a risk, I think, that. partly because of space requirements, some of those essential and rather special aspects of palliative care will be hived off into other areas.

“The internal arrangements of a hospice need a lot of space for equipment, they need a lot of space for relatives (and) they need a large central area where people can engage with each other, so it’s not just like being stuck in a hospital room, but you’re able to come out and live.”

However, SA Health Chief Medical Officer Professor Paddy Phillips told InDaily: “While we understand Professor Maddocks’ concerns, the Palliative Care Working party chose Flinders Medical Centre as the most appropriate location to provide this service after considering a range of different options”.

 “Currently, not every patient at Daw House can be offered single rooms, and in one area four patients are required to share one bathroom.  

“The new, purpose built, state of the art facility at Flinders Medical Centre will feature 15 single bedrooms, individual bathrooms, and a rooftop garden to give people privacy and dignity, as well as access to essential medical and support services.

The gardens at the Repatriation General Hospital are not a private space for palliative care patients and are adjacent to the busy Goodwood Road.

“While these gardens offer areas for relaxation, the new rooftop garden at (Flinders) will have private spaces for palliative care patients and their families, offering panoramic views, clean air and peaceful surroundings.”

But Maddocks said an upgraded Daw House facility on the Repatriation General Hospital site would be more appropriate.

“The campus at Repat would be an excellent place for developing a very comprehensive aged care (facility),” he said.

“The hospice would fit very closely with that.”

The Repatriation General Hospital.

The Repatriation General Hospital.

“That campus could be a major research and training institution and a good care institution, and palliative care would sit very well with that

“The government should have its own guidelines that say (any redevelopment of the Repat site) ought to be directed at aged care. As well as that, it ought to be a good place to put palliative care, because that fits in very well with aged care.

“It would be absolutely appropriate to leave Daw House where it is.”

 

 

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