Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
World Health Organisation, 2002 - WHO Definition of Palliative Care
Palliative Care aims to meet the physical, practical, social, emotional and spiritual needs of patients and carers facing progressive illness that may limit or shorten their lives and includes bereavement support. This care can be provided at any stage following diagnosis. It is for people of all ages to help them live as well as possible.
What does palliative care do?
- provides relief from pain and other distressing symptoms;
- affirms life and regards dying as a normal process;
- intends neither to hasten or postpone death;
- integrates the psychological and spiritual aspects of patient care;
- offers a support system to help patients live as actively as possible until death;
- offers a support system to help the family cope during the patients illness and in their own bereavement;
- uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
- will enhance quality of life, and may also positively influence the course of illness;
- is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.
How is palliative care delivered?
It is delivered via the public, independent, community and voluntary sector organisations working collaboratively to provide integrated services.
General palliative care is delivered by multi-disciplinary teams in primary and community care settings, hospital units and wards. A general palliative approach can be provided by GPs, District Nurses, Allied Health Professionals (AHPs), Social Workers, Pharmacists and so on. Hospital Consultants and their teams can also employ a palliative approach when caring for people with particular conditions. These professionals can introduce the concept of palliative care early on in the patient’s care journey, revisiting the patient’s needs as the patient enters the more severe stages of illnesses such as; respiratory disease, heart failure, renal disease, neurological conditions and dementia. These experts can also recognise if or when referral to specialist palliative care is needed.
Specialist palliative care is the management of unresolved symptoms and more demanding care needs including complex psychosocial, end of life and bereavement issues. This is provided by specialist personnel with expert knowledge, skills and competences. It is delivered by specialist multi-disciplinary teams dedicated to palliative and end of life care. The responsibilities of these professionals will include a very careful assessment and management of physical symptoms such as pain, fatigue, loss of appetite as well as the provision of psychological, social and spiritual support to individuals and their families.
There are four main ways to provide specialist care:
- Inpatient hospice and specialist palliative care units
- Hospital – based services, where multi-disciplinary palliative teams work with patients in wards and clinics;
- Community teams, which provide specialist advice and work alongside a patient’s own GP practice teams enabling specialist care to be provided in the patient’s home or care home;
- Day care, which enables patients to continue living at home while having access to day facilities provided by a multi-disciplinary health and social care team.
How do you access specialist palliative care?
Republic of Ireland
Referral is made using a standard form, available to download from the HSE website. This form is normally signed by the General Practitioner (GP) or any doctor currently caring for the individual with a life-limiting condition.
Referral is a via a referral system and is often initiated by the GP currently caring for the individual with a life-limiting condition.
Where is palliative care available?
It can be provided:
- In the person's own home or where they currently reside - e.g. nursing home or care home
- In hospital
- In hospice