“Incredibly distressing”: Aged care residents blocked from accessing assisted dying

Some aged care residents are being transferred to hospital to access voluntary assisted dying, while doctors say they have had to conduct assessments in carparks after being denied entry to nursing homes.

Melbourne renal and general physician Margaret Fraenkel says she has treated two patients in the past year who were unable to access voluntary assisted dying in their aged care homes. One planned a hospital transfer and another tried to move to a different facility, but both died before receiving the medication.

“They are already stressed about the VAD and their looming death,” Fraenkel said.

“Then they’re shipped out to meet their death in unfamiliar surroundings.”

Fraenkel said this failed to meet federal aged care standards, which say older people have the right to choose to access voluntary assisted dying in their home, “including where their home is a residential care facility”.

The issue comes as a report from Go Gentle Australia found 66 per cent of aged care providers offer no public information about voluntary assisted dying, despite it being legal in every state.

Rosemarie Germano, 82, entered an aged care facility in Melbourne last June and soon said she wanted to access voluntary assisted dying. Her daughter, Susie Germano, said staff told the family “that management doesn’t support VAD” and gave no further guidance.

The home would not allow voluntary assisted dying on site or permit a doctor to assess Rosemarie there, despite knowing she was terminally ill when she moved in.

Susie said her only option was to transfer her mother back to Epworth Hospital, where she had previously been treated for brain tumours that had spread from her kidney. Rosemarie spent three weeks there waiting for approval before receiving the medication.

“It was so incredibly distressing,” Susie said. “She did not want to live any more. Everything had been taken from her so quickly.”

Susie now wants aged care homes to clearly disclose their stance on voluntary assisted dying to prospective residents.

Oncologist Cameron McLaren said he has assessed patients in the car parks of Victorian aged care homes because staff would not allow him on site.

“That’s not the way this should be conducted,” he said. “This is a valid medical consultation. It shouldn’t be cloak and dagger.”

He said some residents have also had to transfer to hospital because their aged care home refused to allow voluntary assisted dying on site.

Go Gentle Australia chief executive Linda Swan said providers were withholding information about their position, leaving residents and families in the dark.

The organisation assessed 70 of Australia’s largest aged care providers and published the results in a report and searchable online database. Of the 12 large providers assessed in Victoria, only one, Regis, received a green tick after publishing website information stating that voluntary assisted dying is available to any resident who requests it, provided it complies with the law.

In South Australia, Queensland and New South Wales, aged care providers must legally inform the public if voluntary assisted dying is unavailable in their facilities. There is no such requirement in Victoria.

Last financial year, Victoria recorded 389 assisted deaths, compared with 1028 in New South Wales, 1072 in Queensland and 480 in Western Australia.

Craig Bardrick, chief executive officer of BASS Care, said his organisation supports voluntary assisted dying and has helped a number of residents since the scheme began in 2019.

“We provide information to residents on request as we believe that it is a personal choice,” he said.

Some providers said they had not published their position because they feared breaching Victoria’s gag clause, which prevents health practitioners from raising the topic with patients. Swan said that was a misconception and did not stop aged care homes from making their policy public.

A Victorian government spokeswoman said providers are expected to include voluntary assisted dying in their end-of-life planning and make their policy available to current and prospective residents.

“We expect aged care providers to be responsive and forthcoming with requests for information regarding VAD,” she said.

The government has passed reforms aimed at making access fairer, including removing the gag clause from April 2027.