2.2.1 Dynamic model of palliative care services

Palliative care services should adopt a dynamic model where the palliative care services will interject at different periods during the condition’s trajectory according to the needs of people with Parkinson’s.

The animation below depicts the changes in belief about when palliative care should be introduced in a progressive condition’s trajectory. It moves from the traditional medical model, where palliative care was only available at the end of life, right through to the present day model, where we now recognise palliative care as a dynamic process. The palliative care input is guided by trigger or crisis points throughout the condition’s trajectory, which may only require palliative input for a brief period. This brief input is to resolve the crisis – such as particularly distressing symptoms, deterioration in the condition or at the start of new interventions, ie gastrostomy feeding – then services are withdrawn until next required.

Download this video clip.Video player: models_of_involvement_pc.mp4
Copy this transcript to the clipboard
Print this transcript
Show transcript|Hide transcript
 
Interactive feature not available in single page view (see it in standard view).

The National End of Life Care Programme’s framework for implementing end of life care in long term neurological conditions [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] (2010) recommends the involvement of palliative care at an early stage in Parkinson’s to improve symptom management and therefore quality of life. Yet research continues to highlight barriers such as lack of awareness and understanding of palliative care services and the failure of some health and social care professionals to discuss the life limiting aspects of Parkinson’s. They therefore find it difficult to determine the appropriate time to initiate conversations about advance care planning (ACP).

If the palliative care approach is adopted by the health and social care professionals from diagnosis, ACP can be integrated into initial care planning and evaluated regularly over the course of the condition.

This will be discussed in greater detail in section 3

2.2 What are the principles of palliative care?

2.3 What is the definition of end of life?