Recently my wife and I had dinner with two very dear friends that we have known for many years. They are sisters who have been providing their ancient father who has advanced dementia with total care for several years. One sister moved in with him. The other sister lives overseas where she has an extended family and comes to her old home regularly to give her sister respite. I had given them copies of my book, and they commented on my views on the need of expert continuing health and palliative care for sufferers of dementia until the end of life wherever they may be. They told me that some time ago they had approached the Regional Palliative Care Service for assistance, which was refused on the grounds that, “he was not palliative”. This is the routine response in such circumstances.
I have had an interest in palliative care for most of my working life. When I trained as a geriatrician in England in the early 1970s I took the opportunity to visit St Christopher’s Hospice in London where I met the great Dame Cicely Saunders. This left a lasting impression of what palliative care could and should be. It is above all a humane philosophy that can be applied in any setting.
While I was the Director of Geriatrics at the Queen Elizabeth Hospital, and concurrently Clinical Director and Executive Officer of the Western Domiciliary Care and Rehabilitation Service, in the Western Region of Adelaide, we developed a network and powerful lobby group made up of people and agencies involved in Aged Care, Rehabilitation, and Community Health. In the early 2000’s we formed a working party to promote Palliative Care which we saw as needed in every corner of our region. We were successful in persuading the Health Minister of the day to fund Hospice beds in a new nursing home opened by an NGO and that was an active participant in our network. With the advent of the funds, the Palliative Care Service was taken over by the hospital Haematology and Oncology Department and our hopes of a comprehensive community-based palliative care service failed to come to fruition.
I attach a PowerPoint presentation that I have made to many groups over the years. Sadly, the deficiencies that are highlighted continue to be relevant to this day.
Aged Care in Australia is a sham. It is an element of healthcare, and residential care should be primarily a level of care, not just an accommodation option.
Dr Mykyta was appointed as a Member of the Order of Australia for services to Geriatric Medicine and medical education in 2012. He has practised medicine for over 50 years and still travels all over South Australia seeing patients. He has treated close to 10,000 patients with Dementia.