2018; Volume 19, No 8, August
Introducing... North Haven Hospice
The IAHPC is delighted to welcome new Institutional Members, and to introduce them to the membership. This month, we are pleased to bring you North Haven Hospice of New Zealand.
‘We Are Guests on a Family’s Journey’
The vision of North Haven Hospice is not to be front and central, but ‘present, around, and supportive. We are guests on a family’s/whanau’s journey.’
The idea of a hospice in Northland, New Zealand, was first conceived by a group of people who, in 1983, gathered to discuss their concerns about the gaps in care and support for those who were dying with life-limiting illnesses in the community.
‘Initially, our vision encompassed becoming a center of excellence and providing world class palliative care wherever it was needed, essential to validate palliative care as a specialty in a sometimes skeptical or dismissive environment. But now, enjoying acceptance and integration with mainstream health services, our vision is altering.’
The Tikipunga base of North Haven Hospice, Te Whare Humarie.
The North Haven hub, called Te Whare Humarie, delivers palliative care across the wider Whangerei area, and provides expertise, clinical support, and education to the Northland region (population: 175,000). A priority is its 24/7 palliative care home visiting service, as is supporting palliative care by whomever is involved, be it other care teams, family/whanau, or others. North Haven also operates the area’s only hospice, with six beds.
Integrated care at all levels achieved by focused planning
At North Haven, clinical care spans both the hospice and the community. This begins at a patient’s first assessment, where an integrated approach and multidisciplinary team cares for both the patient and their family/whanau. While an ongoing relationship with patient, family, and carers focuses on the patient’s physical needs, it also encompasses social and spiritual, cultural, emotional, and bereavement care provided by doctors, nurses, a social worker, counselors, Kaimahi Tiaki Wairua (spiritual care worker), and Te Tumu Manaaki (cultural care worker). A team of volunteers gift Nurturing Touch massage, in-home sitting or support, biography writing, and equipment delivery, as needed.
‘The importance of identifying “circles of care” within the community, and those who are able to support patients who chose to live at home and their primary carers, is paramount. Our core mahi (work) remains, but our sense of responsibility has broadened.’
- Further enhancing patient care has been the development of a ‘shared care plan platform’ called Whanau Tahi, giving key people input and access to the care plan.
- A web-based patient management system, PalCare, allows multiple members of the care team, including general practitioners and medical teams in hospitals, access to specialist palliative care notes and plans. PalCare has revolutionized the sharing of clinical information; each patient’s clinical notes are one continuous story.
- All local GPs are able to phone an on-call palliative medicine specialist and/or specialist nurses around the clock.
Equipping family/whanau carers with timely skills
‘The international Compassionate Communities concept gave us a framework to develop new tools, methodologies, and support systems for equipping carers with the skills and knowledge to assist with caring for their loved ones as they reach the end of life. They learn about patient management, the likely progression of an illness, and how to administer medication.
‘In 2016 we launched a trial of Caring for Carers (Tiakina te Kaitiaki) in Northland. New government funding for palliative care initiatives allowed us to consider the needs of carers of patients with long-term conditions. The intention was to strengthen and allow a support network to grow around the carer so that their resilience would increase.
‘The trial has proved successful and now provides a model for further discussion with the Northland District Health Board, which provides about 64% of North Haven Hospice funding. The remainder is generated by three charity shops, bequests, donations, grants, and fundraising campaigns and activities.
New conversations are building across communities of the north around death and dying as a societal issue and not a health issue, with advocacy and understanding growing in schools, councils, Australian Research Council facilities, and the business community.
North Haven Hospice’s vision — to help grow ‘Compassionate Communities/Hapori Aroha that work together supporting people to live and die well’ — supports ongoing development. Further steps to build community knowledge and resilience aim to reach a point where ‘caring for the dying and bereaved becomes everyone’s business.’