Working to support and care for others

if patients and families feel safe at home it means we’re doing a good job.”

There are only a few patients who do not want to die at home, and that is usually because they don’t want the memory of the death to be with their nearest and dearest.

Allan says the biggest two changes in palliative care over the past 30 years are in medication. The first is the use of battery-operated syringe pumps.

If someone is not able to take medication by mouth, the preferred route, then staff can offer pain, nausea and other forms of symptom relief through a syringe driver.

In the early days injections were administered on a regular basis, though staff moved quite quickly to clockwork pumps then to battery operated, sparing patients a lot of injections. A plastic line under the skin will last for up to five days so patients have one jab every five days to put the line in instead of multiple jabs in a day, Allan says.

The second major change is the clever use of drugs — much more knowledge around the activity of different medications that can do a good job for symptom control.

“That means we’ve got better results from drugs and we’ve got less side effects, particularly with morphine.”

Allan says the community buy-in over the years has been fantastic. About 48 per cent of the hospice’s income needs to come from the community.

“As we have grown, the community has grown with us and has supported our effort year on year.

Yes, it’s getting harder but the community has shown fantastic support.”

Arohanui’s reputation is “absolutely central” to its success.

“Your mum is every bit as important as my mum if it comes to dying. So the standard that we offer is the standard of each and every person that we see.”

Average cannot prevail in hospice. “It is about excellence because every single person deserves that.”

Allan says nurses are the heart and soul of the clinical workforce, absolutely vital in terms of the necessary hands-on care that patients require.

Allan grew up in Aberdeen and did his medical training in that city and in Edinburgh.

His grandfather asked him when he was 6 what he wanted to be when he grew up. “And for reasons that I don’t know, I said ‘I want to be a doctor’. He said why and I said because I want to help people. That remains my basic motivation.”

In 2015, Allan was appointed an officer of the New Zealand Order of Merit for his work in palliative care.

Another misconception about palliative care is if you go in to hospice you die. However, three quarters of Arohanui’s patients who go into hospice go home again.

The in-patient beds are the intensive care part of palliative care where staff deal with very difficult symptoms or stresses on families.

Only 20 per cent of its patients will ever go into the in-patient unit. Eighty per cent are cared for in their home or aged care facility.

Another misconception is it’s a difficult place to work. “No doubt it has its challenges but we find satisfaction in meeting people’s needs in an honest and appropriate way.”