Understanding Palliative Care
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Understanding Palliative Care
The palliative care team
Your palliative care team will be made up of medical, nursing and allied health professionals, who offer a range of services to assist you, your family and carers throughout your illness. Spiritual care practitioners and volunteers can offer practical and emotional support. They may sometimes form an important part of your team.
Depending on your needs, your palliative care may be coordinated by your GP, a nurse practitioner or community nurse, or you may be referred to a specialist palliative care service. These services are made up of a multidisciplinary team of doctors, nurses and allied health professionals trained to look after people with complex health care issues. Your cancer care team will continue to be involved and will work with the palliative care providers at all stages of the illness.
You will have regular appointments or visits with some of the health professionals in your team so they can monitor your progress and adjust your care. The most common palliative care team members are listed in this chapter. You won’t necessarily see all these people – some roles overlap and access to palliative care specialists varies across Australia. Your GP, nurse or palliative care specialist can help you work out the types of services you’ll need.
If you are being treated at end of life and you have cultural or religious beliefs and practices about dying, death and bereavement, or particular family customs, let your palliative care team know. Aboriginal and Torres Strait Islander health workers work with other health professionals to provide care that is respectful to culture.
Possible members of the palliative care team
|General practitioner (GP) or family doctor||continues to see you for day-to-day health care issues if you are being cared for at home (and may be able to make home visits); talks with your nurse and/or palliative care specialist to coordinate your ongoing care; can refer you to a palliative care specialist for help with more complex needs; can organise your admission to hospital or a palliative care unit (hospice) if your circumstances change; offers support to you, your family and carers; can provide referrals for counselling, including bereavement counselling for family and carers, if needed.|
|Nurse||may be a community nurse or a specialist palliative care nurse; may work for a hospital, community nursing service, residential aged care facility or specialist palliative care service; if you are being cared for at home, will visit you in your home and may provide after-hours telephone support; coordinates other health professionals in the team and works out what care you need, including home nursing or help with personal care; helps you manage pain and other symptoms with medicines, treatments and practical strategies.|
|Palliative care specialist, physician or nurse practitioner||oversees treatment for pain, nausea, constipation, anxiety, depression, breathlessness or any other symptoms you may have; usually provides care in a palliative care unit (hospice) or hospital (both for inpatients and for people attending an outpatient clinic); may also be part of a community specialist palliative care service and visit you in your home or in a residential aged care facility; communicates with and advises the cancer specialist and your GP so your treatment is well coordinated; may refer you and your family to a grief counsellor, psychologist or other support person; assists with decision-making about care and treatment.|
|Cancer specialist||may be a medical oncologist, surgeon, radiation oncologist or haematologist; diagnoses cancer and may refer you to a specialist palliative care team; oversees treatment (such as surgery, chemotherapy, immunotherapy, targeted therapy or radiation therapy) aimed at slowing cancer growth and/or managing symptoms of the cancer; may manage some aspects of your palliative care.|
|Counsellor or psychologist||trained in listening and offering guidance; allows you to talk about any fears, worries or conflicting emotions; helps you talk about feelings of loss or grief; assists you and your family to talk together and to explore relationship or emotional issues; might suggest strategies for lessening the distress, anxiety or sadness you and others are feeling; helps you to explore the issues you are facing so you can find more pleasure in your life; may teach meditation or relaxation exercises to help ease physical and emotional pain; provides bereavement care and support to your family and carers.|
|Spiritual care practitioner||may also be known as a spiritual adviser or pastoral carer; supports you and your family in talking about spiritual matters; helps you reflect on your life and, if you choose, may help you in your search for meaning; helps you to feel hopeful and develop ways to enjoy your life despite the illness; may organise special prayer services and religious rituals for you, if appropriate; connects you with other members of your faith; may discuss emotional issues, as many are trained counsellors.|
|Social worker||assesses what support you, your family and carers need, and identifies ways you can receive this support; provides practical and emotional support to you, your family and carers; provides referrals and information to legal services, aged and disability services, and housing support; helps you communicate with your family and health professionals, including about changes to your care goals; discusses ways of coping and emotionally supporting your children, grandchildren or other dependants; may provide counselling and emotional support, including working through feelings of loss and grief; in some cases, may help arrange care for dependants or pets.|
|Physiotherapist||helps to keep you moving and functioning as well as you can; assists with pain relief techniques, such as positioning your body in a better way, using hot and cold packs, and stimulating certain nerves in your body; shows you how to exercise to reduce pain and stiffness; uses a range of manual techniques to help manage lymphoedema, and clear congestion from your lungs, and teaches you breathing exercises to better manage breathlessness; may work with a massage therapist to relieve stiff and sore muscles or swelling, or a podiatrist to treat any foot conditions.|
|Occupational therapist||helps you manage the physical aspects of daily activities, such as walking, bathing, and getting into and out of bed and chairs; advises you on physical aids to improve your mobility and maintain your independence, such as a walking frame or a device to help you put on your socks; organises equipment hire or modifications to your home to make it safer and more accessible (e.g. handrails, shower chair); teaches carers and family members the best ways to move you or help you sit and stand; helps you prioritise your daily activities to conserve your energy for important tasks.|
|Pharmacist||supplies prescription and over-the-counter medicines; can put your tablets and capsules into a medicine organiser (e.g. Webster-pak) that sets out all the doses that need to be taken throughout the week; provides information about how to safely take medicines and possible side effects or interactions with other drugs; communicates with the prescribing doctor if necessary; helps you manage symptoms so you can achieve the best possible quality of life; assists you or your carer with keeping track of medicines, including the costs on the Pharmaceutical Benefits Scheme (PBS).|
|Dietitian||works out the best eating plan for you; helps you choose suitable food and nutritional supplements; tries to resolve any digestive issues, such as poor appetite, nausea or constipation; may work with a speech pathologist, who can assess and help you deal with problems swallowing food and drinks.|
|Volunteer||offers friendship, support and companionship; roles will vary, depending on the organisation they volunteer for; may provide practical assistance, e.g. taking you shopping or to appointments, giving your carer a break, minding children, or doing basic jobs around the house; may be found through a palliative care service – these volunteers are screened, trained and supervised; can also be found through your state or territory palliative care organisation; can be a friend, family member or neighbour – although you may feel embarrassed about asking for help, you will probably find that many people want to do something for you.|
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This information is reviewed by
This information was last reviewed August 2021 by the following expert content reviewers: Dr Cynthia Parr, Specialist in Palliative Care, HammondCare and Macquarie University Hospital, NSW; Dr Lisa Cuddeford, Clinical Lead, WA Paediatric Palliative Care Service, WA; Dr Laura Kirsten, Principal Clinical Psychologist, Nepean Cancer Care Centre, NSW; Penny Neller, Project Coordinator, National Palliative Care Projects, Australian Centre for Health Law Research, Queensland University of Technology, QLD; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; A/Prof Peter Poon, Director, Supportive and Palliative Care, Monash Health, and Adjunct Associate Professor, Monash University, VIC; Dr Kathy Pope, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; Kate Reed-Cox, Nurse Practitioner National Clinical Advisor, Palliative Care Australia; Juliane Samara, Nurse Practitioner, Clare Holland House – Specialist Palliative Aged Care, Calvary Public Hospital, ACT; Annabelle Solomon, Consumer; Silvia Stickel, Consumer; Kaitlyn Thorne, Manager, PalAssist, Cancer Council Queensland; Kim Vu, Consumer; Rosie Whitford, Social Worker – Grief, Bereavement and Community Palliative Care, Prince of Wales Hospital, NSW.