Putting the ‘public’ into public health approaches to palliative and end-of-life care


“Have you ever received or provided first aid for someone – if not, would you know how? What about Last Aid?” asks Associate Professor Jason Mills.

Associate Professor Jason Mills

Today, widespread first aid training has established a societal norm that ensures many individuals possess basic knowledge to provide aid in everyday professional and social settings like workplaces, schools, and community groups.

As part of his education and research into public health approaches to palliative and end-of-life care, Associate Professor Mills shares a similar vision for Last Aid. Last Aid training is just one example of public health approaches that seek to improve health outcomes through increased community participation and access to palliative and end-of-life care.

“A key problem for health and social care professionals providing palliative and end-of-life care is the complexity and growing needs associated with population demographics of more people living longer lives with increasing multi-morbidity. Over time, health services faced with workforce and budgetary constraints simply won’t be able to cope with care needs and ensure equitable outcomes across the population.”

“From a solution-focused perspective, it’s essential to focus on creating innovative public health partnerships that emphasise involving communities in end-of-life care. While healthcare and services are crucial in how we deal with death and dying, they’re not the whole picture. As clinicians and researchers, it’s important to understand that death is mostly a social event with medical aspects, not just a medical issue with social implications.”

Jason elaborates further, “The New Essentials model of public health palliative care embraces a wider scope of care to recognise collective expertise and facilitate collaborative partnerships between health services offering specialist or generalist care, and community/civic sectors across society. This approach ensures that living, dying and grieving well are concerns that we’re all in, together.

To that end, Jason is actively involved in the development, delivery and evaluation of initiatives such as PalliLEARN, Last Aid training, and Ambulance Wish SA – the latter of which was recently launched locally by Palliative Care South Australia, in collaboration with St John Ambulance and Flinders University Research Centre for Palliative Care, Death and Dying (RePaDD), with initial funding of $250,000 provided by SA Health.

Through community/corporate donations and volunteer support, Ambulance Wish SA looks to provide South Australians at the end stage of life with access to the planning, transport, and clinical care they need to fulfil their special wish and create memories that last forever.

“The very real impacts of grief and loss across society often go unrecognised, and programs such as Ambulance Wish are vital because they help to normalise conversations around death and dying, as well as care planning for the end stage of life. Through evaluation, there are also opportunities to demonstrate the impact and broader benefits for society when we think about palliative care as something that we can all play a role in.”

PalliLEARN is an education program that aims to build community knowledge, death literacy, compassion literacy and community capacity in relation to serious illness, dying, death, and grief. It comprises eight 60-minute courses that can be delivered online or face-to-face.

Associate Professor Mills expresses his excitement, stating, I’m looking forward to presenting PalliLEARN outcomes from our collaboration with colleagues in Alberta, Canada, at the McGill International Palliative Care Congress in Montreal, and the Public Health Palliative Care International Conference in Bern, Switzerland, in October this year.”

“Last Aid training is an international public education program that was recently launched in Clare, by Palliative Care South Australia, through funding from Country SA PHN (the primary health network covering the country regions of South Australia). It focuses on dying as a normal part of life, planning, relieving suffering, and final goodbyes. I am excited about delivering the next Last Aid training in Victor Harbor during National Palliative Care Week, and as a member of the International Last Aid Research Group, look forward to further developments in understanding its benefits across society.”

Jason concludes that “Ultimately, death is integral to life – it affects all of us, and I share the vision of the Lancet Commission on the Value of Death in working towards a world where death, dying, grieving and caregiving are recognised as a normal part of life and the opportunity for healthy dying and healthy grieving is available to everyone.

Posted in
Death and Dying Palliative Care