Systemic cracks remain in accessing voluntary assisted dying – support must be better charity says

Go Gentle Australia, a charity that advocates for fair and equitable access to end-of-life choice, including voluntary assisted dying (VAD), has released a new national report. The report, Voluntary Assisted Dying in Residential Aged Care Homes has revealed a fractured approach to providing information and services of VAD across Australia’s aged care sector. While the sample group was limited to 70 aged care providers, the heads of providers who continue to maintain best-practice policies on VAD look to see a national lift in approach, towards a sector standard. The persistent gaps in comprehensive information and full access remain a concern for the seniors qualifying for VAD, family members and the leadership teams who are committed to responding to law in compliance and operational consistency. High performing provider heads highlight that planned and clear resources, to support one of the most weighty and complex points of care in the sector, is a critical operational step in landing excellence in care.

Report findings

Of the 27% of providers surveyed for the report, where VAD access for residents was clear and published, frustration remains that there is still work to be done for consistency across the nation.

For the 34% where there is public information of VAD on organisation publications, there is a growing push for clarity and transparency as a response to the option being a legal treatment option across Australia.

The report found that only 10% of providers were offering comprehensive and full access to VAD, a number that the leadership team of these organisations seek to see rapidly rise.

Advocates and industry leaders across aged care endorse that when it comes to transparency and access to VAD, the need is heightened due to the very delicacy, weightiness and complexity of this option. The widespread gaps in information, process and service, currently in the sector, are a profound concern for the seniors, family members and many staff who are wrestling with powerfully complex physical and emotional realities playing out.

Go Gentle’s CEO, Dr Linda Swan comments, “sadly, this report shows the system is failing older Australians”.

“People entering aged care need to know which health services will be available for them and they need to know that their end-of-life choices will be respected and supported.”

“However, far too many aged care homes do not provide this simple information. This is a core obligation under the Aged Care Act and this lack of transparency and inaction raises serious concerns about how these facilities are supporting their residents’ legal right to access VAD.”

Consistency is care

Provider heads, who have implemented transparency and complete information surrounding the VAD process, are speaking out. Operational updates for the sector must be enacted.

As VAD has passed through national legislative paths, legal across the nation, this most recent report exposes that accessibility, to information, process and options within the sector remain inconsistent and opaque.

For high-performing heads, this confirmation of gaps in standard is an enduring frustration at aged care being painted with one brush. For those that have striven to update information to full and understandable points for all residents, poor-performers yet colour how the sector is seen.

Uniting NSW.ACT CEO, Tracey Burton is one such executive who has been clear on the organisation’s standing and approach. Providing clarity, and being alongside seniors, family and staff that are involved in VAD is not ticking a box, it is integral to providing excellence in care.

Burton and Uniting’s transparent approach are echoed by Swan’s overarching angle to the report, “throughout this research, we asked: ‘What does the experience of trying to access VAD look like from an older person’s point of view?’”

“For too many institutions, the experience is woefully inadequate.”

The report and its findings highlight where approach to transparency needs significant lift. Seeking to uphold transparency as well as honour providers who have set the standard, along with details of non-compliance, the report exhibits best practice examples of providers who have comprehensively and consistently supported residents’ VAD access and choice.

OPAN weighs in

Craig Gear, CEO of Older Persons Advocacy Network (OPAN), has publicly commented on the report, noting its relevancy and guide for immediacy of change.

“It should not be controversial to say that all of us – no matter where we live – are entitled to choose the end-of-life care that is right for us. Where legal, this includes voluntary assisted dying”, Gear says.

“Too often, older people enter residential aged care without knowing whether their end-of-life decisions will be respected. That lack of transparency must change.”

Tools provided

Alongside the report, Go Gentle has published an e-booklet providing guidance for seniors on conversations with aged care professionals about VAD.

For high-performing providers, further support to seniors in navigating VAD is welcomed, many seeing that the resource may well be used by providers as well, in assisting with insight into the questions and confusion that remain for seniors.

Critical insight to consumer sentiment has been understanding the impact of information framing, on accessibility, understanding and quality of support. Advocates and industry leaders continue to advocate for clarity, simplicity and brevity when it comes to the resources and language used in the pointedly complex and sensitive topic of VAD.

The report and Go Gentle’s team, echo this in their findings from talking with seniors, “people at the end of life don’t have time to pore over documents or for long back and forth [with professionals]”.

“These new consumer tools give people the information they need, when they need it, in a plain language format.”

Alongside Uniting NSW.ACT, there remain aged care organisations that will continue to push for a sector wide lift. Improvements can and must be possible, in consistency and transparency, with the provision of resources to contemplate, navigate and decide towards one of the most vulnerable and weighty points of care.