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.”
