If a doctor suggests palliative care for you, or someone you care for, you may not understand what this may mean. Palliative care aims to improve quality of life after a diagnosis of advanced cancer, and offers additional support in the process. People can continue to have cancer treatment while having also palliative care.
1. What is palliative care?
Palliative care is support that helps people with advanced cancer to live as fully and comfortably as possible. The aim is to help someone live as well as they can by identifying and helping with any physical, emotional, cultural, social and spiritual needs. Palliative care can also be helpful for carers or family. Since everyone’s needs are different, palliative care support varies from person to person. Palliative care takes a person-centred approach. This means treating someone in the way they’d like to be treated; listening to their needs, preferences and values, as well as the needs of their family and carers; and involving them in planning treatment and ongoing care.
2. Does palliative care mean death?
When palliative care is mentioned, many people worry it means doctors have given up hope for them, or the person they care for. They may think that palliative care is only for people who are about to die. That isn’t true. In fact, palliative care is about helping people to live in a way that is meaningful to them, within the limits of their illness. For some people, that may mean living as independently as possible, for as long as they can. For others, it means having supportive therapies for side effects as they continue treatment. Palliative treatment is one part of palliative care, that treats the cancer, symptoms or side effects, without trying to cure the disease. It may include treatments such as radiation or chemotherapy, or medications and other therapies.
3. When do you have palliative care?
Research shows having palliative care early improves quality of life. Some people live comfortably for months or years after a diagnosis of advanced cancer and can be supported by palliative care as needed. For others, the cancer advances quickly, and their care is focused on end of life needs soon after their referral to a palliative care service. The palliative care team adjusts the care provided to meet the preferences and changing needs of the person.
Depending on their needs, someone may use palliative care from time to time, or use it regularly for a few weeks or months until their condition is stable. Some people receive palliative care for several years to relieve symptoms.
4. What type of support is available?
Palliative care offers a range of care and support options that can be tailored to meet your individual needs in 5 areas.
Physical needs
Palliative care may include relief from symptoms such as pain, breathlessness, nausea, restlessness and constipation or help with medicines. It can help people with moving around or suggested changes around the house to make things safer. A referral service to respite care can give people with advanced cancer and their carers a break for a short period of time.
Emotional needs
Palliative care can offer support for people, their family and carers to talk about the changes advanced cancer brings or other sensitive issues. It can help to make decisions on what’s important, and to make plans for future care and the preference for where that is given. People with advanced cance and their carers or family may choose to work through feelings with a counsellor or psychologist.
“I see a palliative care person every 8 weeks. Not for direct intervention but to discuss what particular things might be confronting me. It is a security to know that there is a team and individual nurses you can call upon if you need them.” BRYCE
Cultural needs
Palliative care ensures that care and conversations are sensitive to a person’s culture, ethnicity, background, beliefs and values.
Social needs
Palliative care can help people achieve goals and get the most out of each day. It looks at day-to-day needs, such as living arrangements, transport to medical appointments, meals, advice on financial issues or help to set up a support network.
Spiritual needs
This support may come from religious leaders (e.g. a pastoral carer or chaplain), or it may be available from spiritual care practitioners, or other professionals on the palliative care team.
5. Where can you have palliative care?
You can have palliative care in different places, including:
your own home or a family member’s home
at a residential aged care facility or other out-of-home facility
in a hospital
at a specialist palliative care unit (sometimes called a hospice)
at an outpatient clinic or via telehealth.
An important role for a GP or the palliative care team is to work out the best place for care. They consider a person’s care needs, home environment, support networks, and what organisations and individuals are available in their area to help, and then discuss the possibilities with the person, their family and carers. Depending on the situation, it may or may not be possible to receive care at home.
Some people may go into a palliative care unit to get difficult symptoms under control and then go home again.
Usually, hospitals and palliative care units are designed for these sorts of short-term stays, to address worsening symptoms, or for people nearing the end of life.