Five stages of palliative care

What is palliative care?

Most people think that the terms palliative care and end of life care are synonymous. However, they are different. End of life care is care given during the last few weeks of a person’s life and palliative care is undertaken at any stage of a life limiting or life threatening illness.

The focus of palliative care is managing symptoms and providing comfort and assistance. This includes help with emotional and mental health, spiritual and social needs. Some people receive palliative care for years. Early provision of palliative care, at least three to four months before death if not earlier, can improve an individual’s quality of life and reduce burdensome treatments and financial costs. Essentially palliative care is intended to help someone live more comfortably with their ongoing condition.

Palliative care:

• Provides relief from pain and other distressing symptoms
• Affirms life and regards dying as a normal
• Intends neither to hasten or postpone death
• Integrates the psychological and spiritual aspects of patient care
• Offers a support system to help patients live as actively as possible until death
• Offers a support system to help the family cope during the person’s illness and in their own bereavement
• Uses a team approach to address the needs of the individual and their families, including bereavement counselling, if indicated
• Will enhance quality of life and may also positively influence the course of illness
• Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy and includes those investigations needed to better understand and manage distressing clinical complications. WHO.

According to the World Health Organization (WHO), palliative care can help relieve the symptoms of, and treat a wide range, of diseases such as:

• Heart problems
• Different types of cancer
• Chronic respiratory illnesses
• AIDS
• Diabetes
• Chronic kidney and liver disease
• Multiple sclerosis
• Rheumatoid arthritis
• Chronic congenital disabilities
• Neurological disorders, such as dementia and Parkinson’s disease

What are the five stages of palliative care?

Having a chronic disease, or life-limiting illness can take away a lot of freedoms. There is one thing, however, that each individual will always have a choice over, and that is how they would like to receive comfort and care to help manage their quality of life. One path many people choose is by embarking on a palliative care journey. What most people don’t know is, that just like life itself, palliative care travels through different stages, with each stage offering a range of medical, emotional, spiritual and psychosocial support services:

• Stage 1: Stable – Developing and Implementing the Care Plan
• Stage 2: Unstable – Adjusting the Care Plan and Preparing Emotionally
• Stage 3: Deteriorating – Shifting to End-of-Life-Care
• Stage 4: Terminal – Symptom Management, Emotional and Spiritual Care
• Stage 5: Bereavement – Support for Family Members, Loved Ones and Carers

Stage 1

Developing and implementing the care plan will evolve over the process of the illness, but it is commonly started as soon as a resident receives a prognosis of a life-limiting illness or enters the home with one.

Stage 2

If the resident’s illness is displaying worsening of symptoms or new medical problems arise, the nursing and medical team will revisit the care plan and adjust it to ensure that the resident continues to be comfortable throughout their care.

Stage 3

If the resident’s overall health and body functions continue to gradually decline, the palliative care will shift from palliative care to end of life care. For further information on end-of-life care please see our blog here.

Stage 4

When a resident is experiencing a terminal illness and only has days left to live, the primary focus will shift to ensure that the resident continues to be as comfortable as possible. Aside from medical care, the palliative care provided will also focus heavily on improving quality of life for the resident and their families through emotional and spiritual comfort.

Stage 5

In the final stage, the resident has passed away. A loved one’s death can take an incredible toll on family members, carers and all the people who work at the home. The focus of the plan now shifts to providing support to family members, loved ones and carers during their bereavement.

Palliative Care can be organised for you at any of Estia Health aged care homes across NSW, VIC, SA and QLD. For further information on these homes, please visit your preferred location's page here.

What are the different types of informed consent?

Informed consent means that a person understands their condition and its proposed treatment. People usually give their own consent to treatment. Without the information that relates to their medical condition and treatment, a person can't make a fully informed choice and give valid consent for their medical treatment.

Four core criteria must be met:

• the resident giving consent must have capacity
• the consent must be freely given
• the consent must be sufficiently specific to the procedure or treatment proposed
• the consent must be informed.

For further information regarding End-of-Life Care / Palliative Care, please see our blog here.