What Is Palliative Care?

“Today, palliative care is a medical specialty and helps to support people with a wide range of
illnesses including but not limited to; cancer, heart disease, chronic lung disease, AIDS,
 Alzheimer’s and multiple sclerosis.”

Katy talks us through the world of Palliative Care and tells us the rewards and pitfalls of the role.

Topics covered in this article

Introduction

What Does A Palliative Care Nurse Do?

Why Is Palliative Care Important?

Is Palliative Care The Same As End Of Life Care?

What Kind Of Diseases And Issues Do People Receiving Palliative Care Have?

What Are The Mental And Emotional Challenges Experienced By Palliative Patients?

Is There A Typical Age For Someone Receiving Palliative Care?

What Are The Needs Of Someone Who Is ‘Palliative’?

What Kind Of Person Suits A Job In Palliative Care?

What Are The Rewards Of Working With Palliative Patients?

What Are The Main Duties Of A Palliative Care Nurse?

Which Other Healthcare Staff Are Involved In Palliative Care?

Introduction

Traditionally, palliative care was developed only for people who had been diagnosed with a terminal disease, but in recent times palliative care is a term used to describe the care given to people with life-limiting illnesses.

It focuses on the mental, physical and spiritual needs of the patient and aims to provide support through the patient's journey.

Palliative care is provided by Doctors, Nurses, and other specialists working alongside the patient's medical team, everyone works together in order to best support the patient and their family.

What Does A Palliative Care Nurse Do?

A palliative care Nurse provides support and care from the point of diagnosis, up until the last days of life.

As well as ongoing clinical assessments they provide comfort, support, and education to the patient and family members, often acting as the first point of contact throughout the patient journey.

Patient advocacy and optimising the quality of life for patients are a predominant part of palliative care.

Nurses not only work in a clinical environment, ensuring the patient's physical comfort - but they also are always a great source of support and information for the patient and their family.

They are able to advise family and other clinical staff on the patient's progress, answer questions and help the patient make very important decisions.

Why Is Palliative Care Important?

Being diagnosed with a life-limiting illness is an incomprehensible event in a person's life.

At the point when people feel the most alone, is the point where care is the most important; therefore it is vital that a palliative care team is composed of caring, compassionate, and competent professionals, who are there to support every step of the way.

Effective palliative care ensures that the patient is able to live each day to their fullest, whilst pursuing potentially curative treatment or, palliation as a comforting treatment.

Whichever is clinically appropriate and/or preferable for the patient.

The National Health Service focuses on good and supportive Palliative care being able to delay and prevent hospital admissions - but it focuses on the common goal of ensuring the patient is as comfortable and supported as possible so they are able to spend the remaining time they have with friends and family.

As the World Health Organization states, "All people have a right to receive high-quality care during serious illness and to a dignified death, free of overwhelming pain and in line with their spiritual and religious beliefs."

Is Palliative Care The Same As End Of Life Care?

Palliative care is offered at the point of diagnosis and can be provided alongside curative treatment.

End-of-life care is provided when treatment to prolong life is withdrawn and it focuses on the comfort of the patient and emotional support for the family.

The ‘end of life’ is commonly difficult to predict, but it can typically begin when the patient is in the last 6 months of life.

Whilst palliative care focuses on advocating for the patient, providing support and information, whilst clinically assessing and clinical care, end of life care is the process of allowing a patient to die with dignity.

What Kind Of Diseases And Issues Do People Receiving Palliative Care Have?

Originally, in the 1940s, palliative care was only applied in hospice care.

It didn't take long for medical professionals and caregivers to realize that it could be applied more broadly at every stage of life-limiting or very serious illness.

Today, palliative care is a medical specialty and helps to support people with a wide range of illnesses including but not limited to; cancer, heart disease, chronic lung disease, AIDS, Alzheimer’s, and multiple sclerosis.

A lot of palliative care is symptom management, as there are many symptoms that patients experience when they have serious illnesses.

Sometimes it is the illness that can cause pain, immobility, and/or dizziness, and quite often it is the medicine or treatment that can also cause the symptoms, for example in cases where people are receiving chemotherapy or opiates. It is the palliative care teams job to be able to titrate medications in order to have maximum comfort with minimum side effects.

What Are The Mental And Emotional Challenges Experienced By Palliative Patients?

There are many challenges experienced by people facing a long and uncertain journey with a life-limiting illness, research combined with my professional experience suggests that depression and anxiety are the two most common.

However, palliative care professionals are trained to identify and manage a range of mental health conditions such as, but not limited to, delirium and cognitive impairment.Other challenges for someone diagnosed with a serious or life limiting illness, can include changes to family dynamics, and having to manage grief and expectations of loved ones.

Palliative care nurses are experienced and trained in helping the patient and family to navigate this.

Very often patients experience identity issues and a lack of confidence, it can be helpful for the patient to be able to discuss these issues with someone who is objective and removed from the home environment.

Is There A Typical Age For Someone Receiving Palliative Care?

Research suggests that two-thirds of patients receiving palliative care are over the age of 60. However, palliative care is provided regardless of age.

What Are The Needs Of Someone Who Is ‘Palliative’?

By providing relief for various symptoms, palliative care can help you not only carry on with your daily life but also improve your ability to undergo or complete your medical treatments.

The needs of someone receiving palliative care differ from person to person but can mostly be condensed into the following categories; symptom management and predominantly pain relief, spiritual and holistic needs, patient centred care and therefore an advocate for this at each decision making point, services for family support and inclusion, coordination and integrated care, bereavement support and counselling for both the patient and family.

What Kind Of Person Suits A Job In Palliative Care?

First and foremost, a palliative care Nurse must be an excellent communicator, with equal importance placed on the need for compassion and a passion for caring. Palliative care is, in all its simplicity, very sad.

Most Nurses entered into the profession with the intention to heal and treat people, therefore it can be difficult to accept that there may be no cure, or treatment for the illness.

The ability to be able to accept this and work with the clinical team and the patient in order to get the most out of the remaining time or change of circumstance is challenging in itself.

The ability to be able to give everything to your patients, whilst making peace with each individual case and therefore various outcomes, on a daily basis is difficult and requires a specific set of skills.

Nursing requires compassion and excellent listening skills, but when working as a palliative care Nurse this compassion is paramount.

What Are The Rewards Of Working With Palliative Patients?

It is a privilege to be able to care for patients at what is in many cases the most vulnerable and important time of their lives.

When treating a patient with a life-limiting illness the most important thing a Nurse can do is ensure they retain the dignity they are entitled to and be as comfortable as is possible in that circumstance

For me, to be able to provide excellent palliative care, to be able to help and care for patients and their families at a time that is one of the most important, is an absolute privilege.

To be able to comfort a person when they are staring into the abyss of uncertainty and fear is one of the biggest privileges of my career as a Nurse.

What Are The Main Duties Of A Palliative Care Nurse?

Palliative care can be split into three distinct levels that define the duties of nurses working in the field.

The first is primary care.

In this sense, patients will only require Nursing teams to carry out all care tasks. The second is intermediate care.

From this perspective, palliative care Nurses will provide all of the care required but they will act on the advice of specialist palliative care teams.

Finally, complex care, as the name suggests, is more complicated.

It requires a wider approach and long term strategy that includes the duties of palliative care Nurses and wider palliative care teams.

In terms of specific duties, palliative care Nurses must operate across the Nursing spectrum.

They must provide emotional and social support but also clinical care and assessment.

For example, a palliative care Nurse will always listen to the concerns of patients and help patients find important medical information and facilitate family involvement where required.

Many patients with palliative care needs require ongoing help for a range of side effects from treatments.

More often than not this will include extreme fatigue, nausea, vomiting, and generalized pain.

Which Other Healthcare Staff Are Involved In Palliative Care?

A palliative care team is made up of a variety of professionals.

As well as nurses, there are Doctors, Consultants, Pharmacists, Social workers, specialist Nurses and more.

Providing palliative care requires a multidisciplinary approach.

The needs of palliative patients are complex and wide-ranging, that's why it is so important to have a well-trained, diverse and dedicated team.