1 Palliative care
Palliative care is treatment that relieves but does not cure a disease or illness. Palliative care should not bring about the death of the person or delay the death. Its focus is on the physical, psychological, social and spiritual well-being of the dying person, and those close to him or her. It is often used to mean end-of-life care but, as you find out later, end-of-life care is a part of palliative care and so it is not the same as palliative care.
Spend a few minutes thinking about what you understand by the term ‘palliative care’. You might find it easier to reflect back on the experience of someone you know who died recently or someone who is currently having palliative care. If you have not experienced palliative care for someone you know, think about what you understand it should be.
Divide your thoughts into four criteria:
- Physical: how is their body affected?
- Psychological: what are they thinking about and how does it affect their emotions?
- Social: do they have a social life or meet friends and family?
- Spiritual: do they want to talk about the meaning of life or any faith they might belong to?
Use the box below to record your thoughts.
You know from the first paragraph in this topic that palliative care involves the physical, psychological, social and spiritual well-being of the dying person and those close to him or her.
The physical aspects of palliative care might include any medication and pain relief the person is prescribed, and body changes due to age, illness or inactivity. The palliative care focus would be on the physical comfort of the person: being at home or in a hospital is a key consideration, while pain management and hygiene are important for the dignity of the person.
Psychological aspects encompass both cognitive (thinking) and emotional effects that are important during palliative care. The person might be afraid of the process of dying, afraid of what to expect when dead, worried about how their spouse or family will cope or they may have long-standing arguments they want to settle. Palliative care would focus on communication, especially difficult conversations (you can find out more about difficult conversations in Section 1, Good communication), being given information and listening carefully to what the person wants in respect of funeral arrangements, for example, or any bequests.
The social aspects of palliative care include finding out about people the cared-for person would like to see or if there are some things the person would like to do. A palliative care approach might ensure that individuals the cared-for person cares about are informed.
Spirituality is often hidden in our culture but it does not mean it is absent. Opportunity should be given for the cared-for person to express their spirituality, whether it is through an established religion or through a less formal, although significant, part of the cared-for person’s beliefs.
It’s important to remember that palliative care is not confined to people with cancer, as is often believed. It might also be an approach that is used across all ages and a range of conditions, from respiratory disease to dementia.
A key objective is to improve the quality of life of the dying person and those close to them. You will now look at how quality of life can be maximised.