Q&A with Kate Kelly – Director Home Nursing Solutions on the subject of Palliative Care, Death and Dying
Kate who is the founder of Home Nursing Solutions, is passionate about providing great Palliative Care and having this accessible to everyone who needs it.
How long have you been working in Palliative Care?
“It’s been over 20 years in Adelaide and Darwin. Although I did have a few years where I studied law in Charles Darwin University. My passion has always been in palliative care and I wanted to continue working in this field anyway, so I got back into it with home care.
What made you want to work in this field?
I was good at it, good at dealing with sensitive matters and mediating in difficult situations. You need resilience to do it and it can be really exhausting. I was only 18 years old when I got into nursing and palliative care was just part of your nursing work. Back then I knew it would have been much better to die at home rather than in a large impersonal public hospital even though the level of care was excellent.
In my opinion, it is always better to die at home but it may not be affordable and private health cover does not cover palliative care at home as many people believe.
What do you love about Palliative Care?
I love it because people are at their most authentic when their lives are ending, nothing matters more than who they are. They don’t worry about trivialities, they are genuine and real and I love that connection – it’s really human. I love talking to people about their life and death and I might be the only person who can talk to them about their fears, their symptoms and what will happen after their life here ends.
It is a topic that is frightening and affects all of us but we often don’t talk about this until the last minute. I get frantic phone calls from families at the last minute because they did not want to discuss it till then. Then all of a sudden, they need it yesterday.
Even when people are in hospital and they are close to the end, I have heard people around them tell them that they are “looking much better” and that “things are better” when actually they are closer and closer to dying. It’s not intentional to not be honest about it, it is just uncomfortable to discuss but important at this stage.
Over the last 20 years (since you have been working in Palliative Care), have people’s attitudes changed toward death and dying? How have they changed?
Because of the discussion around euthanasia, people are much more aware of it. In general, the policies around Palliative Care have changed and we are seeing a more practical approach with initiatives such as the Advanced Care Directives and we now have Palliative Care departments in hospitals that did not exist before.
But there is still fear around the subject, if we talk about it we are going to feel sad and bad. So we don’t.
And even though there have been changes in symptom management and education about Palliative Care, there hasn’t been a big change in people’s attitudes toward death. If this does not change then we will always struggle with making this stage of life a better experience for everyone concerned.
We treat death as a medical condition just like we do birthing when it is not this. It is a process of living and a part of life and needs to be treated in this way with people empowered to transition through this exactly how and where they want to.
What is the common ground here between cultures that we all share about death and dying?
The emotions during this time are similar and so are the family dynamics. The death of a parent seems to affect the children, no matter what their age. It either brings them closer together or creates rifts with sibling and childhood issues coming to the surface. The fact is everyone wants peace at this time so they are all genuinely trying to find this peace and resolve family conflict. Hence it helps to have someone like me to mediate.
What else would you like to say about the process of dying?
In the case of an elderly parent or grandparent, the amount of people that start talking about the estate and the will before the person has died has surprised me. More than I would have expected.
In my humble opinion, my theory is that if you have an estate, give it all away to who you choose well beforehand so that you can die peacefully. If you are fortunate to have the time and space to consider your death, then ask yourself this question - If you were going to die tomorrow, what do you want to leave behind for your children and their children?
If you die poor because you have completed and finalised your affairs, then this is a good outcome and the people at your bedside are those that really love you.
You will be happier to know you have left goodwill behind. That your family will continue to love and support one another and there will be no resentment or disagreements after you have gone. Leave your affairs and relationships complete – you will have a peaceful transition if you know you have put everything in its place fairly.
You will leave love behind as your legacy, and this will last for many generations to come.”
Kate Kelly - Director, Home Nursing Solutions.
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