Many thanks to the practices who have initiated Just in Case plans within primary care TOP 5 practices in last three months 1. Cicada Health 2. Hairini Family Health Centre 3. Fifth Avenue Family Practice 4. Te Puke Medical Centre 5. Papamoa Beach Family Practice Spotlight: A Medical Consultant at Tauranga Hospital considers patients and their General Practice teams when developing Just in Case plans… What do you see Just in Case plans as being able to offer? There are a few key things I see in JIC plans: a. Avoiding unnecessary hospital admissions/transfers for people who want to spend the last days (or weeks) of their life at home b. The pre-prescribing of subcutaneous meds buys GPs/community services a little bit of time so that some treatment can be initiated by ambulances/hospice nurses before more specialised services could be put into place c. Provides holistic picture of a person's health and social status (if such details are included when JIC is written) for emergency services so that decision making process pre-hospital/in community is easier A Patient/whānau story who had a Just in case plan developed in hospital A Māori man in his 70s with late-stage cardiomyopathy, bronchiectasis, and other medical problems. Lives rurally. Story and perspectives shared by his one of his daughters, and shared with permission. Dad has not been well for such a long time, the daughter says. Over the last year it’s been like a rollercoaster, going in and out of hospital. He had in fact had 12 emergency admissions over 17 months. It was a relief when he got his ‘Just in Case’ plan done she said. This has been the longest he has stayed out of hospital (around 2 months so far). Now we know that there is an alternative, she says, it has been such a relief. Having many whānau members around dad is important too, and this was generally not possible in hospital. Now he can be cared for at home and whānau members can come and go. In reflecting on the experiences of the past year, she says it just became normal that whenever her dad felt unwell that he would push his St John alarm and a crew would come. He would always show really low blood pressure and so they would take him to hospital. He would stay in there for a while. Then he’d come home and a couple of weeks later the same thing would happen again… It was then asked of her – Do you think it would have helped if someone had talked to them earlier about the options around maintaining quality of life, and only doing investigations and treatments for things that would be helpful to him, and promote comfort and quality? She replied, Oh yeah! It would have been helpful if that had happened a while ago [pause]…because a lot of these things [pause]…he would probably be at peace by now, I’m sure. He has had all these blood transfusions and operations and all that, and it was only to keep him alive, not for quality…because none of it has made any difference to him, other than that he is still alive… None of us thought he would make it this this long, the hospital didn’t, and their doctor (GP) didn’t. The biggest challenge now, is the possibility that this just keeps dragging on. For her dad and for all the whānau.
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.