What is end of life care?

What is the difference between palliative and end of life care?

Most people think that the terms palliative care and end of life care are the same. 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.

Whereas end of life care occurs when death is imminent and the care is very different. Read on to see the differences.

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.
  
  

End of Life Care:

End-of-life care includes physical, spiritual, psychosocial assessment and care and treatment delivered by health professionals and ancillary employees. It also includes support of families and carers and care of the person’s body after death. People are ‘approaching the end of life when they are likely to die within the next 12 months.’ This includes people whose death is imminent (expected within a few hours or days) and those with:

• Advanced, progressive, incurable conditions
• General frailty and co existing conditions that mean that they are expected to die within 12 months
• Existing conditions, if they are at risk of dying from a sudden or acute crisis in their condition
• Life-threatening acute conditions caused by sudden catastrophic events

ACSQHC

What are the five priorities of end of life care?

1. The five priorities drawn up for the care of the dying, focus on
   1. Recognising that someone is dying
   2. Communicating sensitively with them and their family
   3. Involving them in all decision making
   4. Supporting them and their family
   5. Creating an individual plan of care that includes adequate nutrition and hydration.

Anderson, P.

Examples of end of life care plan

End of life care is a specialised form of care that is provided to individuals who are near the end of their lives. This care is designed to manage physical, emotional, and spiritual symptoms and to improve quality of life for both the resident and their loved ones. End of life care can be provided in a variety of settings, including at home, in a hospital, hospice or an aged care residence.

Nursing care involves the support of the general well-being of our residents, the provision of episodic acute care and rehabilitation, and when a return to health is not possible a peaceful death. Dying is a profound transition for the individual.

There are various ways to write an end of life care plan. Many hospitals for example have a written, well established plan that is ‘tick the box’ type approach. In aged care, a more holistic approach is taken as it is with hospice practices. The main priorities for an end of life care plan involve ensuring that the following criteria are covered:

End of life care plan

1. Priorities and preferences for care and treatment.
2. Decisions about resuscitation.
3. Views about how and where they would like to be looked.
4. What the resident / patient wants to occur in their last days of life.
5. Who they would like to have with them.
6. Any spiritual or religious beliefs they would like to be considered.

If you have any concerns or questions regarding palliative or end of life care and how this is undertaken within your Estia Health home, please speak to either the Executive Director of your home or the Care Director. If you are not yet in one of our homes, you may always contact us on 1300 682 833 where we can help you over the phone.