One Last Day

We are sharing a very personal story sent to us by a reader living in Goonellabah. Staff member Janet Grist visited Dr Philip West to talk about his moving recollection of his wife Michelle’s final day.

Dr West said that a lot of people don’t realise that terrible things can happen suddenly on any day,

“And when they do happen, they come as an incredible shock and that’s what stands out for you. Your wife is fine in the morning and dead in the afternoon.

“In my case, Michelle lost consciousness so quickly that there was no time to do anything and I could not communicate in any way with her about what was happening. Had she remained conscious, at least for a little while, we could have talked to each other a bit; that would have made a big difference for me and perhaps for her too.”

Dr West went on to say he feels that it is important to talk about death and share your feelings about how much you value the person closest to you.

“I still sit back and think Michelle and I should have talked more about these things. It’s not till your wife is gone that you appreciate how much she meant to you, more than you had realised before. When she’s not there you start to understand just how much you did rely on each other.”

It started out as a normal Saturday morning. We had gone shopping. She bought a gift voucher for her daughter’s partner whose birthday was coming up. I left my boots with the cobbler to have a new set of heels. At the baker’s she bought a party pie for morning tea and I chose a sausage roll. A little before ten o’clock we were home again. We made our coffee and sat out on the balcony in a patch of winter sun to eat our bakery delights. I went off to check my emails and she to start preparing lunch.

Just before half past ten I heard her call out my name. I found her collapsed on the bed, obviously in some distress. It’s her stomach again, I thought. It often gave her trouble, but I was sure it would be better by lunch time as it always had been in the past. But, after a minute or so, I could see it was more than that. She was clutching her head and said, “Cold”. I got her a wet towel to cool it. She started to retch and said, “Bucket”. I got her that to throw up in. Now I could see it was something serious and I dialled the emergency number.

All the ambulances in our town were ‘busy’, the operator said, and it would have to come from the next town, some 30 km away. “Is the patient still breathing?” the operator asked. “Yes”, I said. “Ask her where the pain is now”, the operator said. I put the phone down and went to ask. “She can’t seem to hear me”, I said when I came back. Forty minutes it took the ambulance to reach us. That was a long, long time and I could only sit there beside her as she held her head and couldn’t seem to hear me or speak to me at all.

The para-medics knew their business. Within ten minutes they were ready to take her to the hospital. But their trolley was too large to get into the bedroom and so they rang for help to carry her out. Another ambulance arrived, this time within a few minutes, followed by a fire truck from the local fire station with six firemen ‒ more than enough help. The ambulance took her off and I hurried together a bag of clothing and toiletries that I knew she was going to need. I drove myself to the hospital.

“Do you realise how ill your wife is?” asked the nurse who let me in to the emergency ward. I didn’t, of course. And there she was, lying on a bed with various tubes coming out of her. Soon they took her off for a ‘scan’. I spent the next hour in the waiting room, waiting.

The doctor who had been attending her spoke to me when they wheeled her back. It was a massive stroke, he said. The surgeon specialists had said that nothing could be done and that, if she survived, she would have virtually no conscious brain function left. And so, just after half past five that afternoon, she died as I and one of our friends sat beside her bed in the hospital ward. I think she had known and felt nothing after about an hour from the onset of the stroke.

I’ve always been a realist and I know that these things happen. It’s not been six months yet and no doubt time will do its work and it will get better for me. But, for now, she occupies my mind every waking hour. It wasn’t quite like that before. I’d often spend the day on work or some project or other and think of her only when our paths crossed from time to time during the day.

Two things I’ve had to live with most of all. The first is that it was so totally and utterly unexpected. What had started out as a normal Saturday morning, with a normal healthy wife, ended up as a complete disaster. And secondly, after 34 years of marriage, there had been no chance to say any sort of goodbye or to give her even a little comfort by holding her hand. It will always be with me that her last two words to me were nothing more than “Cold” and “Bucket”.

In her retirement she had been studying Latin. Her text books and exercise books were lying open on her desk where she had been last using them. I bit the bullet a little while ago and tidied them away. But I left her text book open at the spot she had left off, so it would be ready for her when she comes back ‒ pathetic I know, but I felt better for it.

If this story has brought up difficult feelings for you, please get in touch with one of these organisations:

  • Lifeline on 13 11 14
  • Beyond Blue on 1300 24 636
  • MensLine Australia on 1300 789 987

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