What is Palliative Care?
Palliative care is care provided for people living with, and dying from an eventually fatal condition and for whom the primary goal is quality of life.
Palliative care is the relatively new name for the specialised way of providing supportive care for any person with a life-threatening illness approaching the end of life. It is available for everyone: young and old, those with cancer or any other terminal diagnosis, people of any ethnic or cultural background, wherever they live – in the city or in the country.
Palliative Care South Australia is the peak body for palliative care in South Australia. It is a member organisation of the national peak body, Palliative Care Australia.
Our website is an information resource on palliative care and the palliative care services provided in South Australia. The site also announces news, events, online information, publications, learning opportunities, and has links to other relevant websites.
Palliative care aims to comfort, not to cure; to relieve pain and distress for people who are facing death or who are dying.
Palliative care offers support to patients living with a terminal illness and their families, and supports families in bereavement.
The World Health Organisation has defined Palliative Care as an approach that improves the quality of life of patients and their families facing the problems 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.
- provides relief from pain and other distressing symptoms;
- affirms life and regards dying as a normal process;
- intends neither to hasten nor 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 patient’s 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.
Who provides palliative care?
Palliative care can be provided by a number of different health professionals, depending on:
- The needs of the patient
- The resources and needs of the family and carers.
Many health professionals may be involved in delivering palliative care and generally they will work as part of an interdisciplinary team. A palliative care team may include:
- General practitioners
- Specialist palliative care doctors and nurses
- Specialist doctors-oncologists, cardiologists, neurologists, respiratory physicians, geriatricians, surgeons
- Allied health professionals-pharmacists, occupational therapists, physiotherapists
- Social workers
- Grief and bereavement counsellors
- Pastoral care workers
How can I access palliative care?
You can contact the palliative care service in your area directly or through a health care professional. Your GP or hospital doctor may talk to you about palliative care as one option for ongoing professional care and support. With your permission your health care professional may refer you to a specialist palliative care service.
When should I consider palliative care?
From the first diagnosis of a terminal illness palliative care can begin. You and your family can begin palliative care when you need and want support. Your needs might change as the disease stabilises and palliative care services might be reduced or stopped until further needs arise.
Where can I receive care?
Care can be provided:
- at home
- in a hospital
- in an aged care home
- in a hospice
Most people with a terminal condition prefer to receive treatment at home, but this will depend on many factors, including:
- the nature of the illness
- how much support is available from the person’s family and community
- whether the person has someone who can care for them.
What is symptom management?
Some of the common symptoms of illness include pain, fatigue and exhaustion, shortness of breath, coughing, nausea and vomiting, loss of appetite, anxiety. These symptoms call for careful assessment to determine the best treatment plan. This may be managed by your normal health care provider, with support from specialist palliative care staff if required.
What can specialist palliative care provide?
Although the management of a patient with palliative care needs is the responsibility of all relevant health professionals and lay carers (to the best of their ability), the expertise of health practitioners who have specialised in palliative care should be sought as soon as the person’s symptoms indicate the need. The timely provision of palliative care well before the final months of a person’s life, gives individuals and their families an opportunity to plan for as good as possible remaining period of life, as well as to prepare for death.
Specialist palliative care services provide a team of specialist professionals who will work together to meet your needs. Some examples include:
- pain management – including pain assessment, developing a plan of action and monitoring and controlling pain.
- managing other symptoms that can occur when living with a terminal illness e.g. fatigue and exhaustion, shortness of breath, cough, nausea and vomiting, loss of appetite, and anxiety.
- review of medications and liaising between GPs and other health professionals regarding appropriate medications and treatments. This results in a more coordinated approach.
- carer support and respite
- other services including counselling and pastoral care.
What type of practical support can palliative care offer?
Very often a referral to specialist palliative care is made so that health professionals with experience, skills and knowledge about illness, dying, death and grief can then take the lead in the collaboration about a person’s care offering to:
- augment access to other services e.g. home care, assistance with the tasks of daily living, allied health such as occupational therapists, physiotherapists, dietitians etc
- assist with accessing accommodation, transport, travel rebate when requiring treatment away from home
- provide trained and experienced Volunteers who can provide ‘a break or respite’ for carers
Who can receive specialist palliative care?
Anyone living with a terminal illness and their families and/or carers has the right to access palliative care support. This includes, but is not limited to, people living with cancer, end stage heart, lung, renal, and liver disease and conditions such as Motor Neurone Disease, people with mental health disorders or disability.
What is a hospice?
A hospice initially was a place where people who were dying could be cared for in a home like environment but with hospital like facilities and resources. Hospices have now evolved to include temporary admissions for symptom control or for respite for carers as well as a place to die. They are also sometimes known as Palliative/Supportive Care Units to reflect this change.
If someone decides to go into a hospice or palliative care unit, do they have to stay there?
No. People who are admitted for pain and/or symptom management or respite to provide a break for the primary carer can expect to go home again after a short stay.
Can you stop receiving palliative care once you start?
Yes. Palliative care is available when you and your family need and want support. Palliative care services might be reduced or stopped when your needs change or the disease stabilises, but you may recommence care and services at any time.
When should I ask my doctor about pain relief and symptom control?
At any time. However you should keep your doctors or visiting nurse fully informed about any pain or symptoms that you are experiencing. This will assist them with their ongoing assessment of your illness allowing them to be more prepared to select the right medication or other treatments to relieve your distress.
If I am in pain, can it be relieved?
Not everyone with a terminal condition will experience pain. If patients do experience pain, in almost all cases it can be relieved. Pain management medicines can be administered in different ways including, tablets, liquids, injections, and patches. Medicines can also be combined with other treatments to improve pain relief. Other complementary therapies can also assist in relieving pain, such as massage, meditation, acupuncture or aromatherapy.
What medicines are used for pain relief?
Opioids, such as morphine, and a range of other medications are used to relieve pain and other symptoms. Download our Pain Management Brochure.
What are the facts about morphine?
Morphine or other opioids are often prescribed to manage pain. Using morphine or other opioids to control pain may mean that the person is able to enjoy a life largely free of pain or continue to go to work. The appropriate dose of medication will, in almost all cases, continue to relieve pain right through the course of an illness. Morphine and other opioids are not psychologically addictive when properly prescribed for pain relief.
What is a ‘Palliative Care Plan’?
In South Australia it is possible to make your wishes known in advance. Previously known as the “good palliative care plan”, a Palliative Care Plan is a document that records a plan of treatment regarding resuscitation and other possible interventions, after discussion with the patient (if possible), or legally appointed agent/s, family, and staff.
Where can I find more information?