Ageing baby boomers will soon swell the numbers of people dying each year,according to a new report on death and dying from policy think tank the Grattan Institute.
The Dying Well report found death in Australia is highly institutionalised:about 70 per cent of people would like to die at home but close to 80 per cent die in hospitals or nursing homes.
We are living longer than ever before - most people now die between the ages of 75 and 95 - and the majority will die from chronic disease,the report says.
"We have a very institutional,impersonal and medicalised approach to dying,"said lead author Professor Hal Swerissen.
This was because people were uncomfortable talking about death and did not discuss the care they wanted at the end of their lives or write advance care plans,he said.
An advance-care plan is a written statement that outlines a person's wishes for their health care at the end of their life.
It can include treatments they would not wish to have,for example cardiac resuscitation for those who are terminally ill,or intravenous feeding.
Research has found that not only do advance care plans improve the care given to people but their families are significantly less anxious and depressed after they die.
Doctors should be required to discuss end-of-life plans with patients at the 75-plus health check,which is a free check available to everyone,the report concludes.
Advance care plans should also be discussed when:
Given that the majority of people want to die at home,the authors suggest a national reform of palliative care services to cope with the increasing number of patients.
About 15 per cent of people die at home in Australia,compared with about 30 per cent in countries like France,Canada and New Zealand.
The report authors estimate it would cost about $240 million to boost the palliative care system across the country,which would fund about 39,000 more places for patients that wanted to die outside of hospitals.
This cost would be entirely offset by the decrease in patients using expensive hospital care,and offer a significant improvement in outcomes for patients who wanted to die at home,Professor Swerissen said.
The government should also fund a major awareness-raising campaign targeted at people who were nearing the end of their life,and their adult children,he said.
Costing about $10 million,the campaign would encourage these people to write advance care plans and decide who should have their medical power of attorney when they are no longer able to make decisions.
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