I am a health professional

Palliative care needs to be an integral part of health care, especially given the ageing population and the increasing incidence of chronic disease. All health professionals should have expertise in palliative care and know when to refer to specialist palliative care to assist with complex situations.

When should I consider care for a patient?

Palliative care can begin from the first diagnosis of a life limiting illness. It can be provided side by side with treatment to manage complex pain and other physical and psycho-social symptoms with the goals of increased patient comfort and improved quality of life for the patient and their family. There are also clinical triggers for referral to palliative care for chronic conditions such as poor symptom control, frequent exacerbations and/or admissions to hospital.

Role of Health Professionals

General practitioner (GP) or family doctor

continue to see patient for day-to-day health care issues if patient is being cared for at home (and may make home visits)
liaises with the nurse and/or palliative care specialist about the coordination of patient’s ongoing care
refers patient to a palliative care specialist
can organize admission to hospital or a palliative care unit if patient’s circumstances change
offers support to the patients, their family and carers
can provide referrals for counselling, including bereavement counselling 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 patients are being cared for at home, may visit them in their home and may provide after hours telephone support
coordinates other health professionals and works out what care patients need, including home nursing or personal care assistance
makes sure patients have access to medicines and other treatments for pain and symptom relief, and talks to patients about how to take their medicines
can suggest practical strategies to help patients manage their condition (e.g. how to manage fatigue or loss of appetite)

Palliative care specialist or physician

prescribes or recommends treatment for pain, nausea, constipation, anxiety, depression, shortness of breath or any other symptoms that the patients may have
usually provides care in a palliative care unit or hospital (both for inpatients or people attending an outpatient clinic), but may also be able to visit patients in their home or residential aged care facility
communicates with and advises the cancer specialist and patients’ GP to ensure that the treatment is well coordinated
may refer patients and their families 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 patients to a specialist palliative care team
continues to oversee treatment aimed at managing symptoms of the cancer (such as surgery, chemotherapy, targeted therapy or radiation therapy)
may manage some aspects of palliative care

Counsellor or psychologist

trained in listening and counselling
allows patients and their carers to talk about any fears, worries or conflicting emotions that they may be feeling
helps patients and their carers identify and talk about feelings of loss or grief
assists patients and their carers to communicate and to explore relationship or emotional issues
might suggest strategies, techniques and ways of lessening the distress, anxiety or sadness patients and others are feeling
helps patients and their carers to explore the issues you are facing so you can find more pleasure in your life
may show patients meditation or relaxation exercises to help ease physical and emotional pain
provides bereavement care and support to patients’ carers

Social worker

assesses what sort of support patients, their family and carers need, and identifies ways they can receive this support
may provide counselling and emotional support to patients, their family and carers, including working through feelings of loss and grief
assists with communication within the family (including any relationship issues) and with other health care professionals, including any changes to patient’s care goals
discusses ways of coping and how to emotionally support patient’s children, grandchildren or other dependents
can help patients work out ways to record their memories
provides information and referrals for legal matters, financial support, home respite care, meal services, personal alarms and aged care services
may help people with limited support from family or friends to arrange temporary or permanent care for dependents

Occupational therapist or physiotherapist

helps patients to manage the physical aspects of their daily activities, such as walking, bathing, and getting into and out of bed and chairs safely
advises patients on physical aids to improve their mobility
teaches carers and family the best ways to move the patients or help them sit and stand
assists with pain relief techniques, such as positioning patients’ body in a better way, using hot and cold packs, and stimulating certain nerves in their body
shows patients how to exercise to reduce pain and stiffness and increase mobility and energy
uses physical therapy to help clear congestion from patients’ lungs
may work with a massage therapist to relieve stiff and sore muscles or swelling, or a podiatrist to treat any foot conditions

Volunteer

offers friendship, support and companionship
provides practical assistance, e.g. giving patient’s carers a break, minding children, or doing basic jobs around the house or hospital
may be accessed through a palliative care service – these volunteers are screened, trained, supervised and mentored
can also be found through Palliative Care organizations
can be a friend, neighbour or family member – although patients may feel embarrassed about asking for help, they will probably find that many people want to do something for you

Reference

Care Council 2018. ‘The palliative care team’, viewed May 23, 2018, <https://www.cancercouncil.com.au/cancer-information/advanced-cancer/palliative-care/team/#GP>