Doctors propose for over 75s to discuss how they wish to die

TWO Melbourne professors propose doctors have mandatory discussions with people over 75 years old about how they wish to die.

The Grattan Institute's professors Hal Swerissen and Stephen Duckett make four suggestions in the new edition of the Medical Journal of Australia about helping facilitate a "good death" for people.

They described a "good death" as one in which the patient had choices about who would be present, where they would die, what services they would get, and how their symptoms were managed.

Professors Swerissen and Duckett found up to 70% of Australians would prefer to die at home, but only 14% get the opportunity to.

The professors, who described dying in Australia as "highly institutionalized", found 54% of people die in hospitals and 32% in residential care.

Their proposed end-of-life health care reforms include more public discussions, encouraging people to plan better, reorienting services for people dying from chronic illnesses to focus more on their wishes, and ensuring patients have expressed their wishes about the care they want.

They suggest introducing trigger points for mandatory discussions between health professionals and hospital in-patients likely to die in 12 months, people over 75 during health assessments, and all aged care facilities' residents and high-needs recipients of home-based care packages.

They believe from an economic point of view, the costs of their proposed $10 million national education program and paying an extra $241 million to extend the availability of community packages to enable 30% of Australians to die at home would be offset by reduced demand on hospital and residential aged care services and would save $50 million.

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