Jan McGregor has dedicated her life to helping others experience a ‘good death’ – peaceful, dignified, and surrounded by loved ones.“To be cared for by people who love you, and whom you love, is part of community cohesion,” she says. “It leads to a death that is much more peaceful than being cared for by strangers in a clinical atmosphere.”
Jan’s passion for community-based palliative care stems from both professional experience and personal loss.
While working in a leadership role at the Aged Care Complaints Commission, Jan gained an intimate understanding of the distress that inadequate end-of-life care in residential facilities can have on those who are dying. “People shouldn’t have to die in distress—whether that’s physical or emotional,” Jan says. “With the right support, death can be a peaceful, even beautiful, experience.”
When her mother was diagnosed with terminal cancer, Jan quickly recognised the shortfall in the care her mother was receiving – far removed from what she believes a ‘good death’ should be. Heartbroken at the thought of her mother’s life ending this way, Jan made the decision to bring her home, where she personally cared for her during her final days. Though challenging, Jan says caring for her mother through death was a “deeply rewarding experience.”
As a Buddhist, Jan sees death in plain terms – it’s a natural part of life. So, when a conversation with a friend about the importance of a peaceful death blossomed into an idea to start a home hospice rooted in Buddhist principles, her calling was clear – to create a space where individuals could embrace death with dignity and compassion, surrounded by peace and familiarity. “For a lot of people, their home is where they take their refuge. Their garden, the people around them; that’s what’s important to them at the end of life.” And that is exactly what Jan and the team at Pure Land Home Hospice in Adelaide have brought to life.
At Pure Land Home Hospice the focus is on normalising dying, with an emphasis on home and community-based care during end-of-life. “Years ago, death was a normal part of family life, but we’ve lost that connection,” she says. Pure Land seeks to restore that bond.
Providing medical care as well as emotional and spiritual support, their role is to ensure people can die where and how they want, whether that be in their home or surrounded by a community of people. “There’s quite a lot of literature, and eminent people such as Collin Murray Parks, who say critical intervention care is useful, but what’s most useful is to be supported by your own community.”
Pure Land offers a unique model. One that gives equal weight to volunteers and healthcare professionals. Working alongside nurses and doctors, a team of volunteers round out a web of support designed to empower families and carers to create the best-possible environment for the person who is dying. “Our volunteer companions are just as important as the registered nurses and doctors who are working with us,” Jan explains.
“Their role is integral to the care giving process because they help create an atmosphere of care that feels personal and compassionate.”
Every person who volunteers at Pure Land is educated in the spiritual care of the dying, says Jan. “It’s an intensive five day residential retreat that helps people be comfortable with somebody talking about death and dying,” she explains. “And they have to be comfortable talking about their own death too, because if you’re anxious about your own death or dying it’s difficult to help somebody who needs to talk about it.”
For Jan, the care provided at Pure Land goes beyond mere comfort; it creates a sanctuary that honours a person’s values and wishes, emphasising the sanctity of home. “Home is a spiritual sanctuary,” she explains. “To die in that space, surrounded by familiar sights and sounds, offers a deep sense of peace.” This focus on a peaceful death aligns with Buddhist principles, as Pure Land strives to cultivate an atmosphere free from fear and distress, avoiding the sterility of a clinical setting. It’s an ideology that flows freely into their guiding principle: to ensure the dying person and their family are not overwhelmed by existential or spiritual anxiety.
There are certain things that go along with the motivation to have a peaceful death, one that transcends cultures, says Jan. “Dame Cicely Saunders – who is widely acknowledged as the founder of the first modern hospice – said that the way in which a person dies lives on in the memory of those that come after. And so for us, it’s really important that people do have a peaceful death and don’t die in distress, whether that be through physical symptoms or through existential distress.”
While Jan acknowledges not everyone will seek this kind of death, for those who do wish to spend their final days in familiar surroundings, Pure Land is committed to providing the support needed to ensure their death aligns with their wishes. Just as Jan brought her mother home to provide the peace and dignity she knew her mother deserved, Pure Land’s mission is to offer that same opportunity to others: to die free from distress, surrounded by care, compassion, and community.
Pure Land Home Hospice is currently, operating a pilot service, only available within a small geographical area as they test and refine systems. As funding increases and the team grows, their aim is to expand their reach across all metropolitan and regional areas of South Australia.