Oct 6, 2026 · 30 min · 9 segments
In this episode, I'm joined by Mark Kinsela, Chief Executive Officer of Palliative Care WA (PCWA). We discuss what palliative care is, defining quality of life and supporting in through advance care…
And, um, I suppose a very important aspect of that is the advanced care planning and the work that PCWA does there.
How can that help support quality of life in people that are dying or approaching towards the end of their life?
A- advanced care planning for, for your listeners who might, um, have not been involved in, I'm really proud.
Western Australia I think has one of the best advanced care planning frameworks in the country, so something that we should feel very proud as West Australians.
So your advanced health directive, which is a, a sort of, um, a document that is developed by the department that takes you through a series of questions around what is important to you as you, uh, um, get, uh, to the end of your life.
Um, it's a, it's a, a, a fundamental document that really talks about what is quality of life to me, and I think that's one of the really interesting things.
So, um, what we talk to people is, you know, if you were to have a stroke, for example, uh, what are the things that are really important to you in how you live your life, uh, that you might not want to, um, continue to receive support and treatment, uh, if you weren't able to have those things? So one of the great examples that I had, uh, the other day was talking to a woman and she said, "I really love walking my dogs.
Um, I know I'm getting older, I know I'm getting to the end of my life, but one of the things that I really, really love doing is being able to take my dogs for a walk." And so for her, uh, that question around, um, what is, um, quality of life is a, is a very tangible thing.
To other people, it's being able to interact with family members, or have a conversation, or watch their favorite show on television or something like that.
And so once we establish, well, what is a quality of life, then we can ask the question of, well, if that quality is to be taken away from you through a health event, what, what would you, treatment would you like to receive, uh, to the point where that may restore that quality of life? But however, if there is treatment that's, uh, not likely to able, able to restore that quality of life, then I don't wanna receive any treatment.
And so, um, in some of the other states, the advanced health directive or advanced care directive in other states, uh, is really about a withdrawal of care document.
You know, a not for resuscitation, I think we, we used to call it a lot in healthcare.
The West Australian one is really about what is the quality of life that I want, uh, and, um, and how can I achieve that through receiving ongoing care or not? Uh, which is wonderful, and I think advanced care planning is really important that way.
Mm-hmm.
And what, what we actually, there was some very interesting research released, um, just a couple of weeks ago from Queensland, which actually looks at advanced care planning and says a person who's got an advanced health directive in place is 14% less likely To be admitted to an emergency department and 77% less likely to be admitted to an intensive care unit.
And what that actually shows is that a person is making a conscious decision as to the type of care that they want to receive at the end of their life, and they're verbalizing that through the document, through an advance care directive or advance health directive, and that's resulting in them not getting put into an intensive care unit where they're gonna have drips and, and buzzers and bings and machines, and it may not improve the outcome or the quality of their life.
And so they're actually taking that choice to say, "I don't want to receive that care because it's not going to improve my outcome," which is really wonderful, I think, in, in many ways that people can have that choice and control.
And, um, I suppose a very important aspect of that is the advanced care planning and the work that PCWA does there.
How can that help support quality of life in people that are dying or approaching towards the end of their life?
A- advanced care planning for, for your listeners who might, um, have not been involved in, I'm really proud.
Western Australia I think has one of the best advanced care planning frameworks in the country, so something that we should feel very proud as West Australians.
So your advanced health directive, which is a, a sort of, um, a document that is developed by the department that takes you through a series of questions around what is important to you as you, uh, um, get, uh, to the end of your life.
Um, it's a, it's a, a, a fundamental document that really talks about what is quality of life to me, and I think that's one of the really interesting things.
So, um, what we talk to people is, you know, if you were to have a stroke, for example, uh, what are the things that are really important to you in how you live your life, uh, that you might not want to, um, continue to receive support and treatment, uh, if you weren't able to have those things? So one of the great examples that I had, uh, the other day was talking to a woman and she said, "I really love walking my dogs.
Um, I know I'm getting older, I know I'm getting to the end of my life, but one of the things that I really, really love doing is being able to take my dogs for a walk." And so for her, uh, that question around, um, what is, um, quality of life is a, is a very tangible thing.
To other people, it's being able to interact with family members, or have a conversation, or watch their favorite show on television or something like that.
And so once we establish, well, what is a quality of life, then we can ask the question of, well, if that quality is to be taken away from you through a health event, what, what would you, treatment would you like to receive, uh, to the point where that may restore that quality of life? But however, if there is treatment that's, uh, not likely to able, able to restore that quality of life, then I don't wanna receive any treatment.
And so, um, in some of the other states, the advanced health directive or advanced care directive in other states, uh, is really about a withdrawal of care document.
You know, a not for resuscitation, I think we, we used to call it a lot in healthcare.
The West Australian one is really about what is the quality of life that I want, uh, and, um, and how can I achieve that through receiving ongoing care or not? Uh, which is wonderful, and I think advanced care planning is really important that way.
Mm-hmm.
And what, what we actually, there was some very interesting research released, um, just a couple of weeks ago from Queensland, which actually looks at advanced care planning and says a person who's got an advanced health directive in place is 14% less likely To be admitted to an emergency department and 77% less likely to be admitted to an intensive care unit.
And what that actually shows is that a person is making a conscious decision as to the type of care that they want to receive at the end of their life, and they're verbalizing that through the document, through an advance care directive or advance health directive, and that's resulting in them not getting put into an intensive care unit where they're gonna have drips and, and buzzers and bings and machines, and it may not improve the outcome or the quality of their life.
And so they're actually taking that choice to say, "I don't want to receive that care because it's not going to improve my outcome," which is really wonderful, I think, in, in many ways that people can have that choice and control.
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