Hospice Whanganui is implementing a sweep of changes from its 2019 strategic plan, say deputy board chair Kirsten Bryant (left) and chief executive Davene Vroon. Photo / Bevan Conley
Hospice Whanganui is implementing a sweep of changes from its 2019 strategic plan, say deputy board chair Kirsten Bryant (left) and chief executive Davene Vroon. Photo / Bevan Conley
Hospice Whanganui will not help anyone to end their life, but the organisation has services in place for patients who want to hasten their death.
Deputy chairwoman Kirsten Bryant said most of Hospice New Zealand objected to the End of Life Choice Act which came into force in November lastyear, and the Hospice Whanganui board supported that.
Chief executive Davene Vroon said as a hospice "and through our own staff during their employment with us", Hospice Whanganui would not administer a euthanasia service to its patients.
It would, however, provide wraparound services to any patient who decided they wanted to hasten their death.
Under the act, people may get help to end their lives. They must be 18 or older, and New Zealand citizens or residents who have six months left to live and are in unbearable suffering that can't be relieved in a way acceptable to them.
They also have to be mentally competent to make the decision at that time, rather than having opted for it earlier.
If they meet all the criteria, they can get a list of doctors and nurse practitioners who are willing and able to help. The register is with the Ministry of Health, and those on it are trained.
The register is only available to eligible applicants. Vroon said she did not know who was on it, or whether there was anyone in the region on it.
Hospice had staff trained to engage with people who wanted to hasten their deaths, but they would only engage with patients who initiated the conversation.
"We have an obligation to inform people about how to access the service and how to find the right information," Vroon said.
She wants to de-couple the specialist palliative care service the hospice provides from an assisted dying service.
"They should really have boundaries around them. We neither hasten nor postpone death - that's our founding principle," she said.
Hospice Whanganui sees about 350 patients a year, with 65 to 80 at any one time. It aims to help them achieve a dignified and peaceful death.
Most people are cared for at home, but it also has an inpatient unit of five beds, with one set aside for respite care.
It was about the right number of beds for the region, Vroon said.
Fewer than a quarter of patients die in the hospice.
In 2019 the board made a strategic plan with the aim of improving patient care, and it has been putting it into practice.
It reconfigured its management and leadership teams. It added a position aimed at joining together all the aspects of patient care and another aimed at taking care of administration, leaving clinical staff more time to spend with patients.
Another change is a fulltime fundraising role. The hospice gets just under half the $3.2 million it needs to keep running from the Government, via Whanganui District Health Board.
That left $1.6m a year to be raised in the community, Vroon said. Most of it came through its three hospice shops. Covid-19 had decimated its fundraising by forcing the cancellation of community events for two years in a row.
The Covid lockdowns also made new ways of working necessary. Hospice invested in laptops and tablets for staff to use in the field. They can now consult doctors by video call.
Under Covid-19, each Hospice Whanganui inpatient has to choose only two visitors. Photo / Bevan Conley
Covid also led to a limit being imposed of two people able to visit each inpatient, which meant more people had chosen to stay at home.
"They have more freedom there. Our challenge and opportunity is to meet their needs," Vroon said.
Hospice's whānau support team is two chaplains and a social worker, and more investment is likely.
Another change that could result from Covid is an afternoon/evening shift. Hospice gets 70 per cent of its calls between 4.30pm and 10.30pm.
Perhaps the biggest change is a partnership formed with Arohanui Hospice in Palmerston North. Under it, Whanganui has two palliative care specialists from Arohanui on hand for a total of four days a week.
They are doctors Wendy Tsai and Simon Allan, who share the on-call roster with the hospice doctor.
More change was afoot, Vroon said.
The Government's health reforms were likely to push more alliances with surrounding providers, use resources better and reduce duplication. They could also make for more equitable funding across all hospices.
