The Whiddon Group - Redhead Extends the Continuum of Care

The Whiddon Group Redhead is a 59 bed facility located in the Hunter Region of NSW. It has a mixture of high and low care residents and a strong belief in the continuum of care from low care through to high care and palliative care. The staff and management of the facility share a belief in a culture that supports their residents in their home and this has naturally led the facility to nurture the development of its palliative care services and to look after their residents in the end stage of life.

The development of the palliative care service has been going on for a period of approximately 2 years and as Jacqui Findlay, the Deputy Director of Nursing points out, we have had to learn from our experiences and where necessary get back to basics and gap analysis between our services and best practice. Jacqui and the staff still smart from the experience of one death in the facility where post family follow up was not all that it could have been. As Jacqui points out "we learned from this experience a couple of years ago and family comments helped us to strengthen our processes and attitudes". Incidents such as the one mentioned above also led to a full review of our service model and a gap analysis based on the Commonwealth guidelines has proved to be a very valuable exercise. The gap analysis highlighted improvement opportunities such as:

• Contracts with the community palliative care outreach team.
• Better and earlier identification of the indicators for the need for palliative care to ensure where possible a six month lead in time frame.
• Implementation of other support services such as dietician, speech therapist and dental review at earlier stages of the palliative care process.
• Avoidance of room relocation.
• Increased assessments of care plans to weekly or even daily with ensuing application to the Aged Care Funding Instrument.
• Improved and better coordinated staff education.

Through these improvements and a more thoughtful approach, the improved care planning and line charting of the care process has provided families with a much better understanding of what is happening to their loved ones. No longer does TWG Redhead receive criticism from families. The overwhelming comments being made are extraordinarily positive.

As well as these improvements, TWG Redhead has introduced their own ideas for the better care of residents who are dying. The facility has introduced a six monthly memorial service and candle burning ceremony. The service involves a display of photos of the departed residents, a service performed by visiting clergy and the lighting of candles. Jacquie Findlay points out this now popular event enables residents who are otherwise unable to attend funerals to formally farewell their friends and the services are also popular with the families and staff. "One thing we have come to realise is that when we lose a resident our staff also lose contact with families that they have come to love and respect, it is big loss and the memorial services help us all", says Jacqui.

It is through the improvements to the palliative care model and some other important programs that Redhead continues to achieve high and increasing levels of resident satisfaction.

Once upon a time if a resident went to hospital because of a deteriorating condition they sometimes did not make it back home to TWG Redhead. These days it would only be in exceptional cases where the resident does not come home to be with their extended family at TWG Redhead. At any one point in time the facility has 6-10 residents in the palliative care process.

Another side benefit of the improved services has been the attraction of three volunteers to the service. The volunteers provide great comfort to the families by enabling them to have someone by their relatives bedside when they need to be away to take children to school; do the shopping or other necessary things.