Ms Suzanne Bennett1
1Rdns, Parafield Gardens SDC, Australia
Biography:
Suzanne Case Coordinator Manager of the Palliative Team North. BA Science, BA Nursing, Grad Diploma Palliative Care, Certificate in Palliative Care in the Community.
Suzanne has been involved in the Palliative Care field for the last 25 years, with experiences ranging from participating within the “Make a wish Foundation”, in the acute care setting, Sydney Children’s Hospital to the Community Setting here in Adelaide.
Suzanne has advanced knowledge, strong passion and extensive experiences with Clients who choose to have their End of Life Care in their homes.
Abstract:
Background:
A client’s primary Goal of Care (GOC) is often to spend their final days at home, supported by family. Achieving this wish can be complex and emotionally demanding, particularly for those unfamiliar with the healthcare system. Streamlining processes and improving communication can help families fulfil their loved one’s end-of-life (EOL) preferences with dignity and confidence.
Aims:
The project aims to confirm clients’ GOC and ensure they are realistic and achievable through open, collaborative discussions with families. It seeks to identify appropriate End-of-Life Care (EOLC) options for home settings, build rapport and trust, and enhance understanding through clear, empathetic communication. Establishing timely and accurate GOC supports effective planning and facilitates a seamless transition home.
Methods:
Comprehensive and accurate documentation of client and family discussions is completed in collaboration with the multidisciplinary healthcare team. A holistic approach—incorporating comprehensive assessments, such as the Palliative Care Outcomes Collaboration (PCOC) —is employed to guide decision-making.
Effective communication between teams, clients, and families is maintained to ensure clarity and continuity of care. Supportive, culturally sensitive conversations allow clients and families to express values, preferences, and concerns without judgment. The identification of a Substitute Decision Maker (SDM) and early commencement of discharge planning support timely implementation of the client’s GOC.
Results:
Client outcomes align with their identified GOC. Families are supported, informed, and educated regarding EOLC. No client is discharged home for EOLC while being assessed as in the terminal phase. Equipment, medications, documentation, and education are arranged before discharge. Community supports and cultural considerations are integrated throughout care. Palliative Care Standards are embedded within both acute and community settings.
Conclusion:
Collaborative, well-coordinated practice ensures clients’ end-of-life wishes are respected. A clear understanding of home-based EOLC processes among health professionals promotes seamless, dignified care and supports clients to achieve their preferred place of death.