Navigating end-of-life: Options and compassionate conversations

Jeanette Lacey brings over a decade of experience as an End-of-life Care Nurse Practitioner at Newcastle’s John Hunter Hospital, where she led the development of a widely respected palliative care service. Her work spans emergency, ICU, organ and tissue donation, and clinical support with the NSW Ministry of Health. She was Deputy Lead of the NSW Voluntary Assisted Dying (VAD) Clinical Advisory Committee in 2023 and helped shape clinical resources for the implementation of VAD services across the state. Jeanette is also the founding Chair of the Newcastle Compassionate Community and played a pivotal role in establishing Rest Assured.

Palliative care is a form of care described as high-quality healthcare that aims to improve the quality of life for patients, their families and carers. It is person-centered and holistic, addressing emotional, social, cultural, and spiritual needs. It also provides access to resources, including equipment, services and support.

Reference: Australian Government Department of Health and Aged Care

End-of-life planning involves a range of important decisions that help ensure your wishes are known and respected. Important steps to consider include:

• Making a will.
• Appointing an enduring guardian and a power of attorney.
• Completing an advance care directive.
• Discussing palliative care options.
• Creating a funeral or death care plan.

These decisions are not just legal or medical; they are deeply personal. Having open conversations with loved ones and trusted professionals can help ensure alignment and peace of mind. 

VAD is now legal in all Australian states, including New South Wales, as of November 2023. VAD allows eligible adults experiencing intolerable suffering from a terminal illness to voluntarily access medical assistance to end their life. While VAD is one of many choices at end of life, it remains deeply personal and often complex.

Most individuals who pursue VAD are also receiving palliative care, reinforcing the value of a coordinated and compassionate approach. It’s important to understand that VAD is just one part of a broader picture of care that centres on autonomy, dignity and support. 

Jeanette is a strong advocate for community-based approaches to care. Through her work with the Newcastle Compassionate Community, she has assisted develop models where families, health professionals and local organisations collaborate to support people through dying, death and grief. 

This approach reminds all of us that end-of-life care doesn’t belong solely in hospital, it belongs in our homes, our communities and our conversations.