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. Volunteers can also offer practical and emotional support, and may sometimes form an important part of your team.
Depending on your needs, your palliative care may be coordinated by your GP or a community nurse, or you may be referred to a specialist palliative care service. These services consist of a multidisciplinary team of doctors, nurses and allied health professionals specifically trained to look after people with complex health care issues. Your cancer care team will remain involved and will work with the palliative care providers at all stages of the illness.
You will have regular appointments or visits with the health professionals in your team so they can monitor your progress and adjust your care. The most common team members are listed below. You won’t necessarily see all these people – some roles overlap and assistance varies across Australia. Your GP, nurse or palliative care specialist can help you work out which services will benefit you most.
If you have cultural or religious beliefs about dying, death and bereavement, or particular family customs, let your palliative care team know. They can then incorporate these into your care plan where possible.
|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); liaises with your nurse and/or palliative care specialist about the coordination of 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 necessary.|
|Nurse||may be a community nurse, a specialist palliative care nurse or a palliative care nurse practitioner; 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 personal care assistance; helps you manage pain and other symptoms with medicines and other treatments, and by suggesting practical strategies; a nurse practitioner can prescribe some medicines, order tests and make referrals to other health professionals.|
|Palliative care specialist or physician||prescribes or recommends 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 or people attending an outpatient clinic), but may also be able to visit you in your home or 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 choices.|
|Cancer specialist||may be a medical oncologist, surgeon, radiation oncologist or haematologist; diagnoses the advanced cancer and may refer you to a specialist palliative care team; continues to oversee treatment aimed at managing symptoms of the cancer (such as surgery, chemotherapy, immunotherapy, targeted therapy or radiation therapy); may manage some aspects of your palliative care.|
|Counsellor or psychologist||trained in listening and counselling; allows you to talk about any fears, worries or conflicting emotions; helps you identify and talk about feelings of loss or grief; assists you and your family to communicate 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; reflects with you about your life and, if you choose, may help you search for its 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 sort of support you, your family and carers need, and identifies ways you can receive this support; provides information and referrals for legal matters, financial support, home respite care, meal services, parking schemes, personal alarms, laundry services and aged care services; helps you communicate with your family and health professionals, including about changes to your care goals; discusses ways of coping and how to emotionally support your children, grandchildren or other dependents; may provide counselling and emotional support, including working through feelings of loss and grief; in some cases, may help arrange care for dependents 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 and increase mobility and energy; uses manual techniques to help 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||identifies ways to help you manage the physical aspects of your daily activities, such as walking, bathing, and getting into and out of bed and chairs safely; 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 house for a safer, more accessible environment (e.g. hand rails, shower chair); teaches carers and family members the best ways to move you or help you sit and stand; assists you to prioritise your daily activities and conserve your energy so that you can achieve the things that are important to you.|
|Pharmacist||gives you access to prescription and over-the-counter medicines to take at home; can organise your tablets and capsules into a blister pack (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 and your family; 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; provides practical assistance, e.g. taking you shopping or to appointments, giving your carer a break, minding children, or doing basic jobs around the house; can be most helpful if you give them specific tasks so that they don’t have to guess what you need; roles will vary, depending on the organisation they volunteer for; 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.|
This information is reviewed by
This information was last reviewed May 2019 by the following expert content reviewers: Prof Katherine Clark, Clinical Director, Palliative Care, Northern Sydney Local Health District Cancer & Palliative Care Network, and Conjoint Professor, Northern Clinical School, University of Sydney, NSW; Richard Austin, Social Worker, Specialist Palliative Care Service, TAS; Sondra Davoren, Manager, Treatment and Supportive Care, McCabe Centre for Law and Cancer, VIC; A/Prof Brian Le, Director of Palliative Care, Victorian Comprehensive Cancer Centre – The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, VIC; Cathy McDonnell, Clinical Nurse Consultant, Concord Centre for Palliative Care, Concord Hospital, NSW; Natalie Munro, Team Leader, PalAssist, QLD; Penelope Murphy, 13 11 20 Consultant, Cancer Council NSW; Kate Reed, Nurse Practitioner Clinical Advisor, Palliative Care Australia; Merrilyn Sim, Consumer.