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Curtin researchers lead national study into care in the last year of life

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Curtin University researchers have been granted a National Health and Medical Research Council grant of $358,835 for a three-year study investigating the use of emergency departments (EDs) by people nearing the end-of-life.

The research study will be led by Professor Lorna Rosenwax, from Curtin’s School of Occupational Therapy and Social Work, in collaboration with Professors Beverley McNamara, James Semmens and Peter O’Leary.

“People in their last year of life who attend EDs can often be better cared for elsewhere,” Professor Rosenwax said.

“Severely overcrowded EDs, and the staff who work in them, can be poorly equipped to provide suitable end-of-life care.

“Our research will analyse 450,000 presentations to EDs which occurred over a two-year period in Western Australia. It will determine which ED presentations for people at the end-of-life may be preventable through the provision of timely, adequate and appropriate non-hospital services in the community.

“The research will provide much needed evidence to demonstrate how an alternative care pathway can reduce ED demand and cost.”

The multidisciplinary research team want to better understand what health services people use in their last year of life with a particular interest in EDs, but will also look at the use of hospitals and Silver Chain community care.

The researchers trying to determine who uses EDs, which ED visits are potentially preventable and if the use of community-based palliative care reduces demand for, and cost of, ED visits.

“Reasons for ED visits by people at end-of-life are poorly understood. We know that visits to the ED can cause distress and exhaustion for patients and their families, while being clinically challenging and time-consuming for staff,” Professor Rosenwax said.

“We regularly hear about access blocking and overcrowding in EDs in the media. Added to this, many medical, nursing and allied health staff are inadequately educated to manage people requiring end-of-life care.

“With more than seven million ED visits in Australian public hospitals in 2009/10, many of them by older and dying people, it would certainly ease the strain on EDs if people at the end-of-life were provided with a more suitable place of care.”

The study will help policymakers and health professionals determine better resourcing and processes around delivering the best possible care to palliative care patients.

“Our results are aimed at making a difference to the lives of dying people, their families and their friends by ensuring that independent, current and rigorous research informs resource allocation,” Professor Rosenwax said.

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