Mar

08

2021

Talking About Palliative Care With Dr Dan Curley

When you’re fit and healthy, your final days are likely a long way from your thoughts, but palliative care specialist Dr Dan Curley hopes that will change.

Dr Curley trained in medicine in Birmingham, England, and specialised in palliative care at Brisbane’s Princess Alexandra Hospital, He is now part of the Mid North Coast Local Health District’s (MNCLHD) Coffs Clinical Network.

A skilled juggler who took up the hobby more than a decade ago as a form of stress relief, Dr Curley is often called upon to keep many balls in the air at the same time – both literally and figuratively.

“I love it,” he says with a smile. “I came to Australia for a year and 14 years later here I am.”

Two years ago, Dr Curley successfully applied for a research grant with NSW Regional Health Partners to promote the idea of advanced care planning.

The project, Enhancing Advanced Care Systems, runs until 2022 and also employs a clinical nurse consultant and social worker. It began in Coffs Harbour and is now being extended across the MNCLHD to take in the Hastings-Macleay area.

“There are a lot of people who really haven’t thought about death and dying, because often we don’t want to, but life can change pretty quickly sometimes,” says Dr Curley.

“It’s not for everyone, but we know that doing advanced care planning earlier in somebody’s life is much less distressing compared to doing it closer to death, when families might not know your wishes and you can’t express them anymore.”

Advanced care planning involves a person writing down their wishes – called an ‘advanced care directive’. It may also include appointing an enduring power of attorney to manage finances and living arrangements; and choosing an enduring guardian to make legal decisions on someone’s behalf if they are no longer able to.

As part of the project, Dr Curley and his team have been educating and training patients, clinicians, nurses and allied health professionals on the advantages of advanced care planning.

He says one of the most critical aspects of recording your final wishes is storing the completed document, so that it can be accessed easily when needed.

“We suggest leaving a copy with your GP,” says Dr Curley. “We’re also trying to drive the use of My Health Record, where they can be quickly accessed in hospital emergency departments and in wards.

“Through the project we’re aiming to improve the system – educating families to bring advanced care directives to the hospital and educating doctors and nurses to ask routinely if people have any of these documents.

“We also want to track the outcomes for patients. We want to know does it make a difference to their journey. Patients invest a lot of time in doing these things and they’re difficult conversations, so we want to make sure their needs were met towards the end of life.”

Dr Curley is passionate about palliative care and its benefits for patients. He pays special tribute to nursing staff, ‘who do a huge amount of the work and deserve all the credit they get’.

“For me it’s a really satisfying job,” he says. “We tend to specialise in symptom management. If you’ve got terrible nausea or pain affecting every day of your life, we can fix that up pretty quickly and improve the way you live and the quality of your life.

“We talk to people very openly and truthfully about what’s happening to them and what the future may or may not hold.”

He’s also keen to dispel any myths that may exist around palliative care.

“Some people think palliative care is just about dying, or it might be a scary environment,” says Dr Curley. “We’re not really about death and dying, we’re about people living and living as well as they can. We like to really be focused on the patient and their family and care network.”

Aged Care Disaster Management Planning

Strategic Priority Area: One team

North Coast is identified as the region most likely to be impacted by climate change in Australia and also forecasted greatest growth in those 65+.

Healthy North Coast takes a lead role in ensuring the older population and the sector that supports them are prepared for, can respond to and recover from disasters and other emergencies.

We have led eight regional disaster management capacity building workshops, bringing together SES, community organisations and the aged care sector.

We have also developed disaster preparedness tip sheets for both residential and community aged care providers.

Voluntary Assisted Dying

Strategic Priority Area: One team

In May 2022, the NSW Parliament passed the Voluntary Assisted Dying Act 2022. Effective from Tuesday, 28 November 2023, eligible people have the choice to access voluntary assisted dying. 

Healthy North Coast has developed a webpage for both health professionals and consumers, with links to available information and resources.

Living with Dementia resources

Strategic Priority Area: No one is left behind

Healthy North Coast has worked with people living with dementia, their families and local service providers to develop an information booklet that will help them connect with local and national supports along their journey.

The booklet includes commonly asked questions for people to ask their GP and/or specialist.

The resource is available in digital and printed copies, with more than 5,000 distributed across the region. An e-version is available to clinicians via the Dementia and Cognitive Impairment HealthPathway.

Deteriorating Resident Triage Tool Pilot

Strategic Priority Area: One team

The Deteriorating Resident Response Tool (DRRT) has been developed to guide RN’s in Residential Aged Care homes (RACHs) to better understand, anticipate and make clinical decisions responding to the deteriorating health of residents.

The objective of the DRRT is to give RACH staff clear information to triage and provide appropriate care for a range of residents’ health conditions, and, in turn, prevent unnecessary presentations to ED.

The tool has been designed together with a specialist geriatrician, consulting with stakeholders such as Residential Aged Care Managers, NSW Ambulance, GPs, and experts from Mid and North Coast LHDs.

The pilot commences in March with four participating RACHs. Evaluation measures will include effectiveness in building RN confidence and reported reduction in unnecessary hospitalisations. Findings will inform a future planned, region-wide implementation.

North Coast Care Finders Program

Strategic Priority Area: No one is left behind

The Care Finders program is a free region-wide service to support vulnerable older people who have no-one else to help them, to learn about, apply for and set up support services.

Care finders can help people understand what aged care services are available, set up an assessment, and find and choose services. They also help people with access to other supports in the community, both accessing services for the first time and changing or finding new services and supports.

On the North Coast, Healthy North Coast has commissioned four organisations to provide this important service: EACH, Carexcell, Lifetime Connect and Footprints.

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Psychological services in residential aged care homes

Strategic Priority Area: Improving Lives Now

Healthy North Coast commissions two service providers to deliver psychological therapies and supports for older people with, or at risk of developing, a mental illness and who are living in residential aged care homes (RACHs).

The aim of the program is to both provide direct support to residents and their families and carers, as well as upskill the RACH workforce to respond to the needs of residents presenting with mental health concerns.

Social prescribing (Healthy Me Healthy Community)

Strategic Priority Area: Securing a Healthier Future

Delivered by Feros Care, the Healthy Me, Healthy Community program aims to build individual and community connections to reduce loneliness and improve wellbeing in Port Macquarie.

The program helps people to connect with community, activities, supports and services that address their broader social determinants of health, as an alternative or supplement to a clinical approach.

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Digital Health in Residential Aged Care

Strategic Priority Area: Improving Lives Now

Timely access to primary health care professionals, whether through face-to-face consultation or telehealth, is recognised as an issue for many Residential Aged Care Homes (RACHs), that in some cases can lead to potentially preventable hospitalisations. RACHs require adequate telehealth facilities to support access to virtual consultations for their residents.

Project goals

  • Assist participating RACHs to have appropriate telehealth facilities and equipment to enable their residents to virtually consult when needed with their primary health care professionals, specialists and other clinicians. 
  • Provide training to participating RACH staff to support them to have the capabilities to assist their residents in accessing virtual consultation services.
  • Encourage increased use of My Health Record by RACHs, to improve the availability and secure transfer of resident’s health care information between RACHs, primary care and acute care settings.
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Greater Choice at Home Palliative Care Program

Strategic Priority Area: Improving Lives Now

Aims to provide people who have life limiting conditions the opportunity to exercise choice and receive high quality care at home, harnessing improved and better coordinated supports and services that meet their individual needs.

Program objectives:

  • Improve access to palliative care at home and support end-of-life care systems and services (in primary health care and community care)
  • To enable the right care at the right time and in the right place (to reduce unnecessary hospitalisation)
  • Generate and use data to support continuous improvement of services across sectors
  • Use available technologies to support flexible and responsive palliative care at home, including in the after-hours.

These objectives will contribute to achieving the following intended overarching outcomes of:

  • Improved capacity and responsiveness of services to meet local needs and priorities
  • Improved patient access to quality palliative care services in the home
  • Improved coordination of care for patients across health care providers and integration of palliative care services in their region.

Education & training funding elibility

Funding is open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.

Workforce Locum support and R&R funding criteria

  • Available to primary care services in disaster impacted communities within the Healthy North Coast footprint.
  • Available to support short-term workforce coverage, allowing clinicians to rest and recover.
  • Workforce-support funding in total is capped for each site, over a 12-month period:
    • $10k for GPs and/or
    • $5K for nursing and/or
    • $5k administration support and/or
    • $5K allied/pharmacy and other.
  • Funding is not to be used to fill gaps in staffing that have not been able to recruit to and not to replace existing staff.
  • Healthy North Coast will assess requirements and approve available funding directly with the service requesting support.
  • Priority will be given to sites that have immediate, short-term workforce support needs.
  • Requests will be reviewed and supported on a case-by-case basis.
  • Program funding administered via RCTI Agreement (Recipient Created Tax Invoice) to be paid monthly, or on completion of the placement (whichever comes first).
  • Practices will be required to complete a request for payment form monthly, or on completion of the placement (whichever occurs first).

Wellbeing Flexible Funding Criteria & Eligibility

  • Open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.
  • Activity must be purposeful, with the aim of increasing the wellbeing of your team.
  • Requests will be assessed on a case-by-case basis, with funding allocated based on team size.*
  • Following approval by Healthy North Coast, funding will be administered via RCTI Agreement (Recipient Created Tax Invoice) upon providing proof of expenses.
  • Funding cannot be used for the purchase of alcohol, or any other goods or services where the vendor cannot quote their Australian Business Number.
  • Planned activities must occur prior to 30th June 2024.
  • Funding will not be available for retrospective activities.
*Team Size
(Total staff and contractors)
Funding Available
Small (1-5)$500-$1500
Medium (6-20)$1500-$4000
Large (>20)$4000-$5000