The Hospice

We are an Otago-wide community-based service. We provide specialist palliative care services free of charge to those who are faced with terminal illness. We have four community teams based in Dunedin, Central Otago, North Otago and South Otago. We also have an Inpatient Unit in North East Valley, Dunedin.

Mostly care is provided where the patient lives, for example in their own home or in a residential facility. Some of our patients are cared for as inpatients, either in our dedicated Hospice facility or in partnership with community hospitals throughout the Otago region.

In the community, we work closely with primary palliative care providers, such as GPs, District Nurses, hospital and other community-based health teams.

Palliative care is a branch of health care that looks after those with an advanced terminal illness, an illness that has no cure. Care is specific to each person and focuses on helping them to live the best that they can for as long as they are able. This care can be provided in home or in another place e.g. hospice, hospital or long term residential facility.

All health professionals caring for patients with terminal illness try to reduce the burden of illness – this is primary palliative care. It is provided in the community by general practice teams, Maori and Pacific health providers, allied health teams, district nurses, residential care staff and community support services. Providers often have links with specialist palliative care team(s) for the purposes of support and advice, or in order to refer persons with complex needs. They will also have access to palliative care education to support their practice.

When problems are complex or severe, however, patients and families should have access to ͞specialist palliative care.͟ Specialist palliative care is palliative care provided by those who have undergone specific training in palliative care. In Otago, this care is provided by Otago Community Hospice. Specialist palliative care builds on the palliative care provided by primary providers, but at a higher level of expertise in complex symptom management, spiritual support, psychosocial support, cultural support and grief and loss support. Specialist palliative care provides direct support to patients and their families where their palliative care needs exceed the resources of the primary provider alone.

We have a holistic philosophy of care, based on the Māori model known as Te Whare Tapa Wha(the four cornerstones of health). This means we look after the whole person: physically, emotionally, socially, culturally and spiritually. We affirm life and believe in making the most of it. Death and grief are part of life͛s normal processes. We neither hasten nor postpone death. We use modern medicine and therapies to provide relief from symptoms, including pain and distress. We deliver this holistic care via a multidisciplinary team, whose members include Community Care Coordinators (who are specialists in palliative care), palliative specialist doctors, counsellors, a social worker, an occupational therapist and a spiritual care coordinator.

  • Those who have a life-limiting diagnosis with little or no prospect of cure, and whose needs exceed those provided by primary palliative care providers alone.
  • A relative, whānau member or carer of an Otago Community Hospice patient who requires support, advice or education which cannot be provided by primary palliative care providers alone. This support can be provided for up to 12 months after the patient has died.

We have four community teams, based in Dunedin, Central Otago, North Otago and South Otago. We also have an Inpatient Unit in North East Valley, Dunedin.

We care for people with many different life-limiting conditions. These include cancer, motor neurone disease, heart or other organ failure, AIDS, Chronic Obstructive Pulmonary Disease (COPD) and other terminal illnesses.

Usually patients are referred by GPs or hospital clinical staff. Sometimes patients refer themselves. In this instance, we will need to get a GP involved.

After referral, our team assesses the patient to establish whether hospice care is appropriate and to set up a care plan.

We recommend referral to hospice services as early as possible in the process of living with a terminal illness.

First, you will be visited by one of our Community Care Coordinators, who is a specialist in palliative care. A care plan is developed in consultation with you and your family. Care is then shared by our multi-disciplinary team and others already involved in your care ie. your GP, District Nurses, hospital specialist.

Yes. Most people using Hospice services prefer to stay at home, and we do everything we can to support this. Sometimes patients need to spend some time in our Inpatient Unit for more intensive symptom management. More often than not, they return home after this stay. A small number of patients, around one quarter of those admitted, will be too unwell to return home and will stay in the Inpatient Unit until they die.

Our Community Care Coordinators meet with patients and families to discuss their needs and the care services available. They work closely with GPs, District Nurses, hospital specialists and the wider Hospice team coordinating all the services required. We aim to ensure patients are well supported and symptoms are being managed.

Last year our community team members made nearly 13,000 visits and phone calls to our patients and their families/whānau. The more discussions regarding goals and preferences patients have with their care team, the clearer patient/whānau and care team members are about what to do if the patient͛s condition changes quickly. When a patient is at home or in an Aged Residential Care facility, their ͞lead carer͟ remains their GP, with the Hospice staff supporting with specialist palliative care.

  • The patient has needs that cannot be managed in the community or is clearly entering end of life; and
  • Admission is consistent with the patient͛s (and, where appropriate, family/whanau͛s) goals of care.

The Hospice is not a long term care facility. Patients stay until their physical, psychological, social or spiritual needs are met. If the symptoms require intensive input from Hospice staff, then people may stay at the Inpatient Unit and this may be until they die.

Our patients describe our Inpatient Unit as more home-like than hospital-like. We have a holistic and patient-centred philosophy of care. We welcome all-day visiting, and when appropriate support family/whānau staying overnight during the patient͛s admission.

A patient will not be admitted to the Inpatient Unit if:

  • their care needs can be managed well in their place of residence by their primary care providers;
  • their goals, treatment preferences or medical needs might be more appropriately met in an acute hospital;
  • the patient or family do not agree to an admission;
  • a hospice bed is unavailable due to the number of patients being cared for in the Inpatient Unit.

In all of the above situations, our team will continue to provide support to the patient and their family/whānau.

Modern medicines and medical techniques, as well as our specialist knowledge, mean that pain can be controlled for almost all patients. For a very few where managing pain is particularly difficult we will discuss options with the patient and family. On very rare occasions this may mean doses of medications that can cause sedation are used at higher amounts than usual, resulting in increased sleepiness.

Patients with life-limiting illness can be faced with a number of distressing symptoms, including, for example, breathlessness, nausea and anxiety. We have confidence that we can provide relief for the vast majority of patients. We work in partnership with the patient, whānau/family, the patient͛s GP and the District Nursing team to manage symptoms at home. If this proves difficult, patients can be brought into the Inpatient Unit for symptom management.

We have approximately 100 staff. We employ nurses, doctors, care coordinators, a social worker, counsellors, a Kowhai programme coordinator, an education co-ordinator, a spiritual care coordinator, administration staff, cooks and fundraisers. 81% of our paid staff are involved in patient care.

At any one time we look after an average of 205 people, mostly in their own home. In 2017 we cared for a total of 701 people.

At Hospice we acknowledge there are many different views on this emotive and challenging topic and we respect that everyone has the right to their own opinion.

The ethos of hospice, and palliative care as defined by the World Health Organisation, is that it ͚intends neither to hasten nor postpone death͛. This philosophy is a cornerstone of hospice care in New Zealand. Palliative care is holistic – physical, emotional, spiritual, social and cultural needs are all valued equally.

Assisted suicide of any kind is currently illegal in New Zealand, and the Otago Community Hospice, as an organisation, does not support a change in the law to legalise euthanasia or assisted suicide in any form.

We believe greater investment in palliative care will improve end of life care for New Zealanders. From experience we know that with the right palliative care a person can have a good quality of life with their dignity maintained and symptoms managed to help them feel as comfortable as possible.

Good palliative care is founded on a trusting relationship between patient, family, whanau and health professional, which is undermined by euthanasia.

Dying is a natural process and part of life, we must focus on helping people to live well until they die. We would like to encourage people to talk about their wishes when it comes to the end of life, informing family and friends what is important to them.

Rural Services

Yes. We direct all money raised in Otago to Otago Community Hospice services. These are based in Central Otago, North Otago, South Otago and Dunedin.

When patients need an inpatient admission to control symptoms we will offer to admit them to the Inpatient Unit in Dunedin. Sometimes, however, patients prefer to stay in their local hospital. When this happens we will work alongside the local hospital team to assist in providing the best care possible.

Dunstan Hospital, Oamaru Hospital, Balclutha Hospital and Wanaka͛s Aspiring Enliven residence each has one or more beds with an adjoining family area so that families can stay close to the patient. These are not Otago Community Hospice beds. However, our specialist Community Care Team will advise and support the clinicians in these facilities to help them provide care for these patients.

Family / Whānau

Care of family/whānau during these difficult times is very important. Otago Community Hospice offers practical support for families, so call us to see how we can help.

The Kowhai Programme delivers education for unpaid or informal caregivers (usually family members) of patients on the Hospice programme. The Kowhai Programme focuses on the practical skills carers need to know, such as how to help someone transfer from a bed to a chair. Itprovides information on pain management, nutrition, and how to navigate the medical, hospice and home health care systems. Carers are also helped to care for themselves.

The care plan is always developed after discussion with the patient and this will often involve close family. The aim of our care is to have it centred on the individual needs and wishes of you, the person who is ill. Care plans are written in consultation with those identified by the patient as important in helping make decisions. Care plans have many aspects: emotional, spiritual, social, psychological and medical. All of these aspects are considered when creating goals/preference plans in the patient͛s best interest. The care plan can change as needs change. Information will always be available to the patient and their family/whānau and discussion around those changes will always include the patient.

Pets can play an important part in your wellbeing. Provided that your pet is well-socialised and friendly with strangers, we welcome them at the Hospice.

Fundraising

Each year it costs around $6.3 million to run the Hospice. The Government provides about 58% of our funding and we have to fundraise for the remainder. We don͛t charge patients or their family for any of their care.

Families often like to thank the Hospice in some way for looking after their loved one. There are many practical ways you can help us. For example: by making a regular donation, organising to leave a bequest in your will, donating high quality goods to our shops or volunteering. Learn more about supporting us.

Yes, we do. Nearly 400 volunteers support our operations in roles such as kitchen assistants, receptionists, companions in the Inpatient Unit, gardeners, shop assistants and biographers. We also need volunteers for our annual Hospice Awareness Campaign in May. Our Coordinator of Volunteers Rebecca Shaw ensures the smooth selection, training and management of volunteers. We are very grateful for the support we receive from our volunteers - without them we wouldn't be able to provide our quality service. Find more information on volunteers or contact Rebecca on 03 473 6005 for information on how to join our fabulous volunteer team.

We have seven charity shops throughout Otago. There are two in Dunedin and ones in Mosgiel, Oamaru, Cromwell, Alexandra and Milton. You can support our shops by donating any quality items you no longer need. They have a wonderful array of curated goods, both contemporary and vintage. Find out more about our shops.