What is palliative care?

• Palliative care: an approach that improves the quality of life on 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
• Offers a support system to help patients live as actively as possible until death
• Enhances quality of life and may positively influence the course of illness
• Can start early in the course of illness, in conjunction with other therapies that are intended to prolong life e.g. chemotherapy/radiotherapy
• Includes investigations needed to better understand and manage distressing clinical complications
• The holistic model of palliate care involves consideration of the four areas of well-being: physical, psychological, spiritual and social

When should palliative care become involved?

• Around the time of diagnosis
  • Early discussions about disease and patient preferences
• During treatment
  • Including curative treatment
• Following treatment
  • Disease-free - treatment related symptoms
  • Recurrent disease
  • Metastatic disease and/or poor prognosis at diagnosis
  • When dying - 'end of life care'

Recognising dying

• Worsening weakness and performance status
• Worsening physiological status with no reversibility
• Struggling to maintain oral medicines
• Losing interest in food and fluid
• Sleeping more
• Reduced level of consciousness
• Physiological and biochemical changes, skin colour, cool to touch, altered breathing