Effective palliative care delivery calls for a method of support that goes beyond providing medical treatment. It aims to provide comfort and respect by offering specialised support for individuals with serious health issues.

It consists of a caring, holistic approach that focuses on easing pain and improving life quality for the person. We’ll look into the 5 stages of palliative care to see how it helps make the journey easier and better for those who need it, starting with a clear explanation of what palliative care really is.

What Is Palliative Care?

Palliative care is focused on providing comfort and improving the quality of life for people facing serious, advanced illnesses approaching the end of life, aiming to help them and their families live as fully and as comfortably as possible. It addresses the person’s physical, emotional, and spiritual needs in a caring and supportive manner.

What Diseases Does Palliative Care Cover?

Palliative care is for any serious life-limiting illnesses, including but not limited to:

Cancer
Heart failure
Chronic obstructive pulmonary disease (COPD)
Dementia
Neurological disorders
Renal failure
Liver disease
HIV/AIDS

It is important to note that palliative care is not exclusive to these conditions and can be applied to a wide range of serious illnesses. It is also worthy to note that palliative care is often carried out by a multidisciplinary team of healthcare professionals, instead of just one health discipline or speciality.

The Palliative Care Team

The composition of a palliative care team may vary, but it commonly comprises of the following members:

Palliative Care Physician

A physician with specialised training in palliative medicine will lead the medical aspects of care, managing symptoms, coordinating treatments and addressing the overall medical needs of the patient.

Registered Nurses

Nurses will be appointed to give ongoing treatment, providing hands-on care, administering medications, managing symptoms, and offering emotional support to both patients and their families. Treatments can be provided in a hospital or in the comfort of one’s own home.

Social Workers

They will be assisting mainly with navigating complex social and emotional aspects, through the provision of counselling, support with advance care planning, and connecting patients and families with community resources.

Spiritual Care Provider

Religious or spiritual groups are also commonly included in a palliative care team to assist patients address their spiritual and existential concerns. From support with attending services to visits at home to practice their faith, religious groups offer emotional and spiritual support to patients and their families.

Psychologists or Counsellors

Mental health professionals are trained to listen, offer guidance and ongoing support to help individuals cope with the emotional challenges of serious illness.

Occupational Therapists

These will be the personnel assisting patients in maintaining their independence in daily activities, addressing issues related to mobility, self-care, and overall quality of life.

Pharmacists

Palliative care pharmacists specialise in medications commonly used for symptom management, ensuring proper dosages are administered and minimising potential side effects.

Nutritionist/Dietitians

These are the specialists who will provide guidance on dietary needs, addressing issues related to appetite, weight management, and overall nutritional wellbeing.

Carers/Support Workers

Carers and Support Workers provide the following support:

Physical Care – They assist with daily activities such as bathing, dressing, toileting and feeding, ensuring the person is comfortable and their basic needs are met.
Emotional Support – They offer companionship, empathy, and a listening ear, providing emotional support to both the individual and their family members as they navigate the challenges of end-of-life care.
Respite Care – They provide respite for family caregivers by taking over caregiving responsibilities for short periods, allowing family members to rest and recharge.
Domestic Assistance – They may assist with household tasks, meal preparation, and running errands to alleviate the burden on the person and their family members.
Maintaining Dignity and Quality of Life – They uphold the person’s dignity and autonomy, respecting their wishes and preferences regarding their care and quality of life.

Palliative care requires allied health professionals to collaborate with the patient and their family to create a comprehensive care plan aligned with the patient’s goals and preferences, with such care extending to their family members as well as they recognise the profound impact serious illnesses can have on their physical, emotional and social aspects of life.

The 5 Stages of Palliative Care

Palliative care traverses through 5 stages, each stage representing a pivotal chapter in an individual’s and their family’s experience throughout this journey of managing the complexities of their illnesses. Here’s what each stage entails:

Stage 1: Stable (Initiation)

The first stage involves the initiation of palliative care. This typically begins when a serious illness is first diagnosed. The person is in a stable condition.

Symptoms and health issues will be identified and managed through a comprehensive plan that includes immediate treatment, future follow-ups, and ongoing assessments to adjust medications and symptom relief as needed.

Moving to a hospice can be beneficial, but healthcare professionals prioritise maintaining independence for as long as possible. It’s important to express any preferences for specific treatments or staying at home. Efforts will be made to accommodate these wishes, often including support from in-home carers, nurses, and other health professionals during palliative care.

Stage 2: Unstable

As one’s condition evolves, new/unexpected symptoms could arise or existing symptoms could worsen. This is the second stage – the ‘unstable’ phase – where immediate changes will need to be made to one’s care plan.

Continuous monitoring and adjustments will be made to maintain comfort and dignity, using medications, therapies like massage and music, and other interventions. Emotional and mental support is also provided to patients and their families, offering a space to express fears, hopes, and concerns.

This stage fosters a collaborative approach so open communication is encourage, with the patient’s wishes guiding the decision-making process. Psychologists, counsellors, mental health professionals, and religious groups (if applicable) are usually involved at this stage.

Stage 3: Deterioration

As one’s illness progresses, their overall health and body functions start to decline with severe/complex medical conditions continuing to develop. This is the ‘deteriorating’ stage, meaning more adjustments to one’s care plan is required.

The team will transition from palliative to end-of-life care, engaging in discussions with the individual and family to understand their wishes and facilitate shared decision-making about treatment preferences, including hospice care if applicable. This ensures a dignified and compassionate end-of-life experience.

During this critical time, emotional and mental health support is crucial. Many individuals may have only weeks or months to live, causing significant distress for families. Palliative care provides education on what to expect, guidance on home care, and emotional support to help families cope with the impending loss.

Stage 4: Terminal

As life draws to a close and an individual may have only days remaining, palliative care intensifies to prioritise comfort and reduce distressing symptoms.

Priority is placed on ensuring a peaceful and comfortable environment, tailored to the individual’s preferences, including cultural and spiritual practices. Decision-making is guided by personal values, encompassing medical interventions and resuscitation, with end-of-life medications and spiritual services readily available.

Stage 5: Bereavement

The last and final stage, it is when the individual with the terminal illness has passed on. The care plan will now shift to providing support to family members and loved ones, helping them cope by addressing the multifaceted aspects of grief and loss.

Amongst others, here are a few key components of bereavement services provided by palliative care:

Grief counselling: individual or group counselling sessions are arranged for family members to have a safe place to express their emotions. Information on normal grief reactions, coping mechanisms, and strategies for self-care will be provided to help them understand and cope with the range of emotions they experience.
Support groups: palliative care teams may facilitate or connect bereaved individuals with support groups, offering them a sense of community. Participants get to share their experiences and gain insights from others, receiving mutual support during the grieving process.
Spiritual support: through a faith leader or spiritual care providers, such support addresses existential questions and provide comfort based on the individual’s beliefs and values.
Assistance with practical matters: bereavement support can actually extend to practical matters such as navigating legal and financial issues, accessing community resources, and providing assistance with funeral or memorial arrangements.

Bereavement support in palliative care is personalised, acknowledging the uniqueness of each grief journey. Support levels adjust to individual needs, with palliative care teams conducting follow-ups with family members to ensure their well-being, offer continued assistance, and connect them with further resources as required.

Meeting Your Palliative Care Needs

At Absolute Care & Health, we’re deeply aware of the challenges faced by individuals and their loved ones during palliative care and end-of-life stages. Compassionate, holistic support is crucial for those confronting serious illnesses.

Our commitment is to ensure seamless integration of our in-home care and support with your medical or Palliative Care team for comprehensive care.