Australia is confronted with a "silver tsunami" of people facing death with little infrastructure in place to cope with such a seismic shift in population, according to a leading American palliative care doctor.
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Dr B. J. Miller said there was a huge workforce of largely ignored potential carers who could be reimbursed, trained and supported to keep people out of hospitals and hospices and die at home.
"Hospitals are no place to live and die, that's not what they were designed for," he said
"There is a distinction between a disease-centred and a patient-centred model of care, and here is where caring can become both creative and less expensive.
"Don't get me wrong. I love hospitals. I work in one. I was saved by one."
Now 45, Dr Miller of the University of California San Francisco Helen Diller Family Comprehensive Cancer Centre, had his own a near-death experience at 19.
In 1990, he was a sophomore student at Princeton University who climbed on top of a tram after a party and 11,000 volts arced from the power line through the watch on his left hand, running through his body. Severely burned, he lost both legs below the knee and his left forearm.
Today he walks, hikes, and bikes on carbon-fibre prosthetics that look like supple metallic bones.
In Australia to address the NSW Palliative Care Association annual conference at Broken Hill next Saturday, Dr Miller was a keynote speaker at a University of Sydney lecture, Dying Re-imagined: designing a better way to die, on Thursday.
He shared the stage with Kate White, professor of palliative care nursing Kate White and and professor of palliative care medicine Rod MacLeod.
Professor MacLeod said surveys showed up to 80 per cent of people had indicated they wished to die at home.
"Fourteen to 16 per cent manage to do it," he said.
However, Professor MacLeod said there were ways of changing such a reality: a consortium funded by NSW Health to assist people to die at home and comprising HammondCare, Sacred Heart and Calvary Healthcare had provided care for 1700 people, largely with voluntary workers and 73 per cent of them had achieved the goal of dying at home.
Professor White suggested consideration should be given to teaching students about death in the same way they receive sex education as part of the curriculum to help families with palliative care.
"Imagine having a unit at high school where students were taught how to support someone at home, or support a family. They don't need to provide personal carer, but maybe they could be helping out in the home," she said.
Asked about the role of euthanasia, Dr Miller said changes to legislative in the US state of Oregon had seen a 0.4 per cent rise in overall suicides but a questioner from the floor who said suicide rates where euthanasia was legal in Europe had climbed to 4 or 5 per cent.
However, the question was deemed a speech.
Dr Miller said modern societies had started to fear death in a way foreign to previous generations.
"Society used to be more agrarian and never far away from the cycles of life. People saw animals dying, children dying at childbirth, from sickness. You couldn't seduce yourself that you were somehow not part of nature, most knew death was not this exotic affair that it has become," he said.
"We are wired to run away from the subject but it's changing.
"Climate change reminds us we are captive of the natural world. We thought we were independent. But the sheer volume of Baby Boomers has reawakened the idea that nature wins."
