Palliative Care Providers for those in Newcastle, Sydney & Across NSW

Toby is an 82-year-old man living with prostate cancer that has unfortunately spread to his bones and liver. Despite that he is fiercely independent and determined to stay at home with his wife of 60 years, Elsie. Toby’s liver metastasis caused a lot of problems with pain and vomiting a few months back, and he had a clinic appointment with Palliative Care Associates that helped settle down the symptoms. Over the last two or three days, however, Toby has become more unwell. He is a bit more confused than normal and his pain is worsening again. Elsie is getting quite concerned about him. It’s not an emergency…and she doesn’t think he needs an ambulance…but he’s certainly not himself.

In situations like this Palliative Care Associates can organize a planned admission to either Warners Bay Private of Lake Macquarie Private hospital for assessment and management. It’s hard to know exactly what’s going on for Toby- it might be as simple as an easily treated bladder infection or the start of a far more serious deterioration. Whatever is going on private hospital admission will allow the tests and assessments he needs to be done efficiently and will save Elsie from worrying about him at home.

Brian is a 60-year-old man with severe emphysema. He has had lung disease for many years but over the last year he has required oxygen at home. His specialist has tried everything but there isn’t really anything that can be done to improve his lung function. He has been finding the work of breathing is getting harder and harder. His son, David, has organized for him to move in with him and his family because it has been getting too difficult for Brian to manage at home on his own. Over the last month David has taken his dad to the public hospital twice when he has become suddenly more anxious and short-of-breath. The hospital has been great and obviously tried their best…but the Emergency Department was so busy and on one visit they spent 12 hours there waiting for a bed. Brian was discharged the following day because the hospital was full. When David arrives home from work, he finds that his dad is distressed, has some pains in his chest and is severely short of breath again.

In this situation presentation via the Emergency Department at Lake Macquarie Private is an excellent choice. They can rapidly assess and treat Brian and he will be quickly transferred to the most appropriate ward. Respiratory specialists and general physicians and even intensive care are available on-site. In hospital Palliative Care Associates can optimally manage Brian’s breathlessness. Importantly PCA can also use the admission to provide education for both Brian and David about the illness and symptom management. They can also lead important discussions about future planning and decision-making to ensure that Brian’s wishes are honoured.

Jill is a 45-year-old woman with Multiple Sclerosis. It is a serious illness and she has excellent support from her GP and from the specialist neurologist who has looked after her for the last 5 years. Jill is very satisfied with her care except for one thing…she has read a lot about the role of medical cannabis in treating some of the symptoms of MS and would really like to try it. Her specialist says it’s a load of rubbish and refuses to discuss it and her GP seems vaguely supportive but is not willing to prescribe it herself. Jill is very reluctant to access the drug illegally- not because she’s particularly anxious about that side of it, but because she wants to know what she is using is safe. She also knows that it’s pretty expensive however you get it and she’d prefer to pay for the ‘real thing’ rather than a bottle of what could be anything! Her other concern is that she has read that medical cannabis can interact with some other medications and can affect the liver in some people, so she wants it to be prescribed properly.

Palliative Care Associates can assess Jill and prescribe medical-grade cannabis products safely and efficiently. The advantage of PCA prescribing, rather than a stand-alone cannabis clinic, is that the doctor at PCA will thoroughly assess the symptoms and identify anything that needs to be investigated. We can organize clinic-based review and prescribing of safe, available medicinal cannabis products and keep both her GP and her specialist fully informed.

Joe is a 70-year-old man who has been at the John Hunter Hospital for 2 weeks. He has a long history of heart problems, high blood pressure and type two diabetes. He also suffers from dementia and, although he has been managing at home, things have been becoming more difficult. Over the last year he has had significant problems with falls, severe back pain and poor blood flow to his legs. Because of his heart problems the surgeons have been unable to operate to help the blood supply and he has quite severe pain in his legs quite often. Although his condition improved initially, he has been deteriorating for the last week. His family agrees that he is more tired, eating less, is finding it harder and harder to get out of bed and has episodes of worsening confusion. Although the care in hospital has been excellent, he is in a noisy four-bed ward and the team do not seem focused on his pain as much as he would like. His family become concerned when they are called to a meeting to discuss discharging Joe. They do not feel that he is well enough to manage at home but are told that he may need to be sent to a nursing home if he cannot be cared for.

Palliative Care Associates can organize transfer of Joe to either Warners Bay Private Hospital or Lake Macquarie Private Hospital. The rooms are bigger, quieter and often private, particularly at WBP. Although all hospitals have length-of-stay criteria they are much more flexible in the private system. Joe can have his pain and other symptoms carefully managed and PCA can also facilitate referral to other specialists including geriatricians if needed.

Natasha is a 46-year-old woman who sadly has progressive lymphoma. She was diagnosed several years ago and had remission after bone marrow transplant. Unfortunately, the disease reappeared, and she has undergone multiple episodes of both chemotherapy and radiotherapy including some trial drugs. Her haematologist has been caring for her wonderfully for almost 7 years now. Currently Natasha is admitted to Lake Macquarie Private Hospital due to yet another infection and has been receiving high-dose antibiotics. She is in pain and feels sick and tells her family that she has had enough treatment now and has accepted that she has incurable disease. Her family is upset but want to respect her wishes. In their heart-of-hearts they know that Natasha is right and that the end of her life is approaching. Her condition deteriorates rapidly, and she becomes agitated and distressed and appears to be in pain.

A doctor from Palliative Care Associates can treat Natasha’s pain and other symptoms and work along-side her haematologist. When the decision is made to withdraw life-prolonging treatment we can seamlessly turn the complete focus towards comfort and dignity-based care. We are experts in the management of complex and difficult symptoms and in the utilization of specialised medical regimes of pain relieving, anti-nausea and sedative medications via continuous subcutaneous infusion.

As you can see from the scenarios above Palliative Care Associates can help you and your family at many points in your disease journey. We are happy to provide clinic or hospital-based care and can work alongside your usual care providers or manage your care in a purely palliative paradigm. We give you choice, comfort, control and dignity when it matters most.

Elsie is a 93 year old lady who lives in a nursing home. She lost her husband Fred of over 60 years some 3 years ago and was struggling to cope with living alone. Reluctantly she and her two daughters decided that she needed to transition to aged care six months after Fred died. She was pleasantly surprised after she settled into the nursing home at the level of care she received and the new friends that she made. Her daughters and their children visit her regularly and she looks forward to seeing them and her room is filled with family photos and artworks made by her grandchildren.

Recently she noticed blood in her urine and the nurses reported this to her GP who visits the facility. Her GP decided that an ultrasound of her kidneys and bladder was indicated and unfortunately this revealed that Elsie had a large mass in her bladder. She found having the ultrasound challenging enough so further and more invasive investigations were out of the question. This mass was almost certainly bladder cancer and given her age and frailty no treatment was offered.

She accepted that she would soon die but became worried that she would suffer a painful death. She did indeed begin to feel some discomfort in her bladder a week’s later and her GP prescribed some pain-killers which initially worked but when her pain became worse her GP was uncomfortable with increasing her pain relief, worrying that she may hasten Elsie’s death.

Her daughters had a meeting with the nursing home staff and were reassured that they could provide end of life care for Elsie at the nursing home but they left that meeting with some uncertainties.

Fortunately, Elsie had continued her private health fund membership and her daughters made an appointment to see a Palliative Care Associates doctor in the clinic. (We are more than happy to discuss patient care with families without someone as frail and unwell as Elsie having to be present). It would be decided that one of our doctors would visit Elsie in the nursing home and then arrange for her admission to Warners Bay Private Hospital where she died peacefully three weeks later.

Her daughters were extremely grateful for the care she received form the dedicated, experienced and caring nurses and the way that her doctors kept Elsie comfortable and allowed her to die a peaceful death, quite the opposite of what Elsie had imagined for herself. The large private rooms allowed her daughters to take turns having “sleep-overs” with their mother in her last days and the private lounge on the ward allowed her family a private place to gather during her last days and a place to begin their grieving after she died surrounded by her family.

Elsie is a 93 year old lady who lives in a nursing home. She lost her husband Fred of over 60 years some 3 years ago and was struggling to cope with living alone. Reluctantly she and her two daughters decided that she needed to transition to aged care six months after Fred died. She was pleasantly surprised after she settled into the nursing home at the level of care she received and the new friends that she made. Her daughters and their children visit her regularly and she looks forward to seeing them and her room is filled with family photos and artworks made by her grandchildren.

Recently she noticed blood in her urine and the nurses reported this to her GP who visits the facility. Her GP decided that an ultrasound of her kidneys and bladder was indicated and unfortunately this revealed that Elsie had a large mass in her bladder. She found having the ultrasound challenging enough so further and more invasive investigations were out of the question. This mass was almost certainly bladder cancer and given her age and frailty no treatment was offered.

She accepted that she would soon die but became worried that she would suffer a painful death. She did indeed begin to feel some discomfort in her bladder a week’s later and her GP prescribed some pain-killers which initially worked but when her pain became worse her GP was uncomfortable with increasing her pain relief, worrying that she may hasten Elsie’s death.

Her daughters had a meeting with the nursing home staff and were reassured that they could provide end of life care for Elsie at the nursing home but they left that meeting with some uncertainties.

Fortunately, Elsie had continued her private health fund membership and her daughters made an appointment to see a Palliative Care Associates doctor in the clinic. (We are more than happy to discuss patient care with families without someone as frail and unwell as Elsie having to be present). It would be decided that one of our doctors would visit Elsie in the nursing home and then arrange for her admission to Warners Bay Private Hospital where she died peacefully three weeks later.

Her daughters were extremely grateful for the care she received form the dedicated, experienced and caring nurses and the way that her doctors kept Elsie comfortable and allowed her to die a peaceful death, quite the opposite of what Elsie had imagined for herself. The large private rooms allowed her daughters to take turns having “sleep-overs” with their mother in her last days and the private lounge on the ward allowed her family a private place to gather during her last days and a place to begin their grieving after she died surrounded by her family.