What is Palliative Care?

Palliative care is about caring for people with a life-threatening, or terminal illness as well as their family and friends. It aims to ease the pain, distress and other physical, emotional, or spiritual problems that may arise in the course of illness.

Palliative care adds to the range of medical treatments and services already being provided and works together with the specialists, general practitioners and nursing staff already involved. Sometimes palliative care helps in the decision making about when to stop some treatments.

The goal of palliative care is achievement of the best possible quality of life for patients and their families and friends. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with treatment aimed at cure.

Palliative care services care for everyone regardless of their race, culture, background, religion or belief system. Palliative care is available for all people of all ages.

Care in the home and elsewhere

Specialist palliative care can be provided at home, in aged or residential care, and in hospital settings. It can be provided in conjunction with other care and services.

It is a matter of choice for the patient, family and carers depending on their preference, and their ability to cope in the setting of choice.

Anyone can refer/ask for this service

Referral to palliative care can be by the patient, a family member or friend ( with permission of the patient), a GP, specialist, or other health care provider.

Where the referral has not included the patient's own medical practitioner the palliative care service will seek the patients permission to contact the relevant practitioner.

When to ask for care or help?

Early referral can enhance the quality of life and health for people with life limiting or terminal Illness.

Palliative care services in recent years have been available for people with a terminal illness who are dying usually within the last six months.

However, today, many people live with a life threatening or terminal illness over a much longer period of time, from weeks, to months, and years.

Palliative care services can offer assistance from the earliest time possible - from the time of diagnosis, during the course of illness, and in conjunction with treatment aimed at cure.

Reasons for referral

Many people receiving palliative care have cancer, but some have diseases like motor neurone disease, HIV/AIDS or end stage heart, lung or kidney failure. As palliative care is developing, more people with diseases other than cancer are being cared for.

The person with the illness, their family, friends and caregivers are all recognised as people to whom care is provided, so reasons for referral may be for any of:

•  Symptom management

•  Emotional and/or psychological support

•  Home care issues

•  Social factors requiring support

•  Deterioration in condition of the patient

Initial contact by the service is usually within 24 hours of receiving the referral, most often via a telephone call to the patient and/or carer to arrange a time for assessment.

Cost?

Community based palliative care services in the Loddon Mallee Region do not charge a fee for their service.

However other services such as district nursing, allied health services and others providing care in conjunction with the palliative care service may charge fees.

 

Loddon Mallee Palliative Care Services

Loddon Mallee Palliative Care services offer individuals, family and carers early access to health and community services and provides opportunities to plan for future health needs.

A wide variety and combination of palliative care options are available to patients, including home and community-based care, hospice, and acute care.

Palliative care services provide access to a range of services. These may be nursing, medical care including consultancy to the person's GP, day care, counselling, diet advice, loan of equipment, physiotherapy, occupational therapy, social workers, bereavement support, pastoral care and a wide range of support from trained volunteer workers.

Clients with specific cultural and linguistic needs are catered for with access to assistance available through appropriate trained personnel.

Medical Care

•  An aim of palliative care service provision in the Loddon Mallee Region is work with the patient's general practitioner as the key medical practitioner in their care.

•  Following referral and with the patient's permission the patients own general practitioner is contacted in the first instance.

•  Medical oncology, radiation, psychiatry, surgery, anaesthetics, and specialist pain medical practitioners are available within the region. Some medical specialists are available in the sub-regions. Regional General Practitioners can access local specialist medical personnel, or lead agency specialised medical personnel, as required.

•  Palliative care services in the Loddon Mallee Region endeavour to ensure patients have access to 24 hours 7 day a week medical practitioner support.

If they are unavailable, the general practitioner on call at the nearest acute facility is contacted or patients are advised to go directly to the nearest acute facility (via ambulance if necessary).

Nursing Services

•  Specialist palliative care nurses undertake admission assessments and develop care plans with the patient, carer, and family. All palliative care services provide care in conjunction with District Nursing services.

•  District Nurses deliver general nursing care, whilst the specialist palliative care nurses provide specialist palliative care advice and support, undertaking reassessment, as well case management (if required and for complex care in particular).

•  Depending on the situation, an on-call service may be provided by the service - initially via telephone and, where the services resources available permit, a follow up visit.

•  If resources are not available to provide this then the palliative care service ensures the client/carer/family are aware of whom to contact locally.

This may be, for example, the local on-call medical practitioner (who is aware of the clients circumstances), the local hospital, or an ambulance if necessary.

Specialist Palliative Care Nurses

• Undertake the initial assessment, and regular re-assessment of palliative needs and support required by each patient/client.
• Enable the patient/clients to maximise choices for care and the site of delivery of care.
• Liaise closely with the patient's general practitioner and other medical specialists (eg. oncologist, radiotherapist); members of the interdisciplinary team, and other services and service providers to ensure client needs are met.
• Ensure continuity of care regardless of location
• Advocate for the patient when necessary to ensure palliative care needs are met eg. With other service providers, during inpatient episodes, ensuring the patient, family, and carers are informed and involved in decision-making.
• Provide consultation and advice regarding ongoing management of pain and symptoms of the illness – at acute, acute on chronic, and terminal stages of illness.

Utilise a health promotion approach to care and education ensuring that the patient, carers, and family are able to manage as confidently and independently as possible.

Provide advice and support together with the patient, carers and family to enable them to plan and devise strategies for coping as resiliently as possible when problems and events occur.

Ensure there is 24-hour after hour's support/service to patients and carers as the need arises.

Facilitate the provision of aids, appliances, medication, etc, necessary to enable the client to remain in the home.

Ensure appropriate ongoing loss and grief support.

Ensure Bereavement follow-up for the family and significant others.

Provide assistance, advice, education, and support for other staff involved in care.

Allied Health Services

All services have links with local hospitals and/or services including allied health services which enable them to provide comprehensive palliative care to ensure that physical, psychological, social, and spiritual supports are available.

Loss and Grief and Bereavement

Palliative care aims to make the person feel in control of their treatment and their quality of life. It involves family and friends, recognising that they, too, need to be prepared for the death of someone they love, as well as being there to offer help and support during the grieving process.

•  Loddon Mallee Palliative Care Services support the patient, family and carers through the time of illness ensuring there is access to assistance from other services such as pastoral care, counselling, respite and other support services

•  Bereavement support for the next of kin/carer, is provided as needed, for up to a period of twelve 12 months from the time of death of the patient.

•  Nurses and volunteers, who have experience in bereavement support, provide this service. It is a monitoring role - to provide support and education about normal grief reactions, determine risk factors, and identify abnormal grief patterns should they occur. Bereavement follow-up may include attendance of Palliative Care Nurses at the funeral and a visit to the bereaved usually within two weeks or sooner if required, or necessary.

•  Information booklets, resources, referral and advice are provided as required.

•  Memorial services arranged by the sub agencies are held regularly throughout the region.

•  A Bereavement Risk Assessment Tool, to identify factors influencing a person's reactions to grief, may be used as appropriate.

•  A Bereavement Support Plan is formulated for bereaved clients. The plan includes a structure of regular visits. The plans are a guide only, and other visits may occur between the intended visits if necessary.

•  If abnormal grief experiences occur the person is referred on to specialist Grief Counselling. The initial cost of this specialist counselling comes from regional funding set aside for this purpose. This ensures that individuals are referred on to appropriate services, and that cost is not a factor in client refusal of service.

 

Volunteer Support Workers

Trained volunteer workers provide support to patients, families and carers. Volunteer support workers liaise closely with patients (one on one), with the extent of their involvement determined by needs.

 

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