Background:

The management and response to VAD in the community context and manner and timing of death of individual’s accessing palliative care and VAD requires further exploration.  The complexities surrounding palliative care services and voluntary assisted dying (VAD) have been well established since the Voluntary Assisted Dying Act 2017 (Vic) was introduced.

Aim:

To evaluate the experience of community palliative care clients participating in VAD and support other healthcare organisations in understanding and exploring this end-of-life choice.

Method:

Data was collected over a period of 45 months on community palliative care clients who had sought access to VAD. A retrospective analysis was then performed to assess the manner and timing of death of individuals. 

Results:

A total of 108 clients wanted more information about VAD during this period. These deaths were reviewed. Of those, 28 clients (26%) died from administration of the VAD substance. The median age was 70 years, 54% male, 46% female. All had a malignant primary diagnosis. Preferred site of death (PSOD) met was 100%. Median length of engagement with palliative care was 115 days. This equates to 1% of total deaths that occurred within our organisation. 

A total of 80 clients (74%) died without administration of the VAD substance. The median age was 69 years, 60% male, 40% female. Almost all (90%) had a malignant primary diagnosis.  PSOD met was 72%. Median length of engagement with palliative care was 90 days.  

Conclusions:

Palliative care is an important aspect of end-of-life care and can provide specialist support for individuals accessing VAD. Whilst all palliative care clients evaluated had access to VAD, only a quarter of clients died from administration of the VAD substance. Further evaluation and research to ascertain why the VAD substance was not administered for the remaining clients would provide greater understanding in this area.