Palliative-PatientPalliative care is an approach to care for a person who has an advanced illness with little or no prospect of cure.

In simple terms, it’s a level of comprehensive care designed to meet the physical, mental, and spiritual needs of chronically ill and dying patients.

The aim of palliative care is to achieve the best possible quality of life for the person and provide support for their family and carers.

The World Health Organisation defined palliative care as an approach to care that:

  • affirms life and treats dying as a normal process
  • neither hastens nor delays death
  • provides relief from pain and other distressing symptoms
  • integrates the physical, psychological, social, emotional and spiritual aspects of care, with coordinated assessment and management of each person’s needs
  • offers support to help people live as actively as possible until death
  • offers support to help the family during the person’s illness and in their own bereavement.

Some of the common medical conditions of people requiring palliative care include  cancer, HIV/AIDS, motor neurone disease, muscular dystrophy, multiple sclerosis and end-stage dementia.

Palliative care goals include to:

  • ensure that patients receive excellent pain control and other comfort measures
  • provide patients with the information they need to be able to participate in decisions about their care
  • offer practical, emotional and spiritual support as approprite
  • obtain expert help in planning care outside a hospital

Dr Michael Barbato, a retired Sydney doctor who has been in medical practice for more than 40 years and has been a palliative care physician for over 20 years and considered an expert in the field says there are three important elements to palliative care:

Physical comfort. For someone living with a life-limiting illness, every second, every minute and every hour of every day is precious if only because time is now in short supply. How long a person lives is important, but much more important is the quality of the time. Pain, more than any other thing, erodes whatever opportunities there are for healing. For this reason pain control is an important, if not an essential ingredient for the healing process to take place.
A nurturing environment – one that is comfortable, homely and includes all that the dying person considers precious. This includes the people he/she loves, favourite music, books, pictures, photos, paraphernalia, etc.

A healing presence – people, particularly family and friends, who can sit with the sick or dying person and share their pain, laughter, sadness, joys, fears, passions, reminiscences and even their silences without feeling they need to make ‘things’ better.
Of these three, pain relief is the most important, for there is rarely healing without it.”

Palliative Care in Australia still hasn’t gained  with many people including Dr Yvonne McMaster OAM advocating for increased funding and an increase in palliative care services in New South Wales.
The demand for palliative care services across Australia is expected to increase over time due to the continued growth and aging of the population. In addition, the pattern of disease at the end of life is changing such that an increasing proportion of people are expected to die from chronic progressive illnesses—people with such illnesses are most likely to make use of palliative care services.
NSW Ambulance program 
The NSW Ambulance has a new protocol  for paramedics to treat palliative care patients in southern NSW after hours and in their own homes. The NSW Ambulance Authorised Adult Palliative Care Plan (NSW AAAPC Plan) is completed by the palliative care patient’s GP in consultation with the patient and their family. Once approved, in the event of an emergency 000 call out by the patient, the NSW AAAPC Plan specifically authorises paramedics to deliver individually tailored treatment based on the GP’s orders as documented in the plan. This may include administration of medications and other actions to relieve and manage symptoms in the home rather than needing to be transported to hospital.

USEFUL LINKS re palliative care:
Australian Institute of Health & Welfare

Palliative Care Australia

NSW Cancer Council

Department of Health

Caresearch