Managing a chronic disease or terminal illness is extremely difficult on your own. Even the most supportive family may struggle while attempting to give you the full care and attention you need and deserve. That’s where a Palliative Care program can help.
A structured program and dedicated care team can prove the difference when ensuring individuals managing illnesses continue living to the highest quality possible. Today, we look closely at what a Palliative Care program involves, including how each of the Palliative Care phases – known formally as the 5 stages of Palliative Care – are designed to support people physically and emotionally with diligence and dignity along their journey.
What is Palliative Care?
Many people live with a chronic or terminal illness that can only be managed rather than cured. Palliative Care refers to the process of treating the symptoms of these illnesses to make them manageable, reduce pain and optimise the comfort for those living with serious conditions. It can also mean the care provided by medical teams to people approaching their end of life.
Lots of complex or chronic illnesses require Palliative Care, including:
- Cancers (all types)
- Diabetes
- Multiple Sclerosis
- Dementia
- Parkinson’s disease
- Chronic respiratory conditions like dust disease
- Kidney or liver disease
- Arthritis
Most Palliative Care services are provided at home using qualified professional nurses and carers or in registered care facilities, hospitals and hospices. This allows individuals to receive person-centred care in their preferred setting wherever possible.
As patients progress through various stages of their illness, they will require unique types of care along their journey – and end of life stages of Palliative Care have different demands to the early stages. Using the formal Palliative Care process gives an individual the best opportunity to improve quality of life, receiving optimum care at the right time from the right teams to minimise pain and all the while, meeting their personal and clinical needs.
The Palliative Care Team
Because of the many types of chronic or terminal illnesses requiring Palliative Care – not to mention the varying stages of an illness – a broad team of health professionals is involved.
General Practitioner (GP)
A GP provides guidance and works collaboratively to ensure your diagnosis and medical history are considered when deciding the type of medical treatment required to manage symptoms and pain. They are involved whether a Palliative Care patient lives at home, in a residential care facility or hospital.
Registered Nurses
Following the guidance of a GP, a nurse or group of Palliative Care nurses are responsible for administering medical support in the home, care facility or hospital.
Carers
A carer provides non-medical support to a patient at home, including personal care (help to bathe or dress), social care (listening and chatting) and any domestic chores the patient struggles with, such as cooking and cleaning.
Allied Health and Other Health Professionals
Most patients will struggle with the mental impact of a chronic or terminal illness and may need the services of a psychologist or counsellor. The illness or treatment may also lead to difficulties with communication or swallowing and a patient will require a speech pathologist.
What is Included in Palliative Care?
Depending on the disease or illness and its impact on the patient, a different type of care will suit one individual better than the next.
Thankfully, Palliative Care includes all kinds of support to cover patients’ physical, mental, social and personal needs over time. Here are some of the more common types of care you can expect to find available in a Palliative Care program:
- Support with physical pain – likely through administering regular medication
- Help with essential daily tasks like personal hygiene, dressing and eating meals
- Psychological support through ongoing counselling
- Auxiliary care (transportation to see a GP, visiting the shops or support groups)
- Wound management
- Continence management
- Physical and emotional support for family members
- Help with planning for end-of-life
What are the Levels of Palliative Care?
Contrary to what many people think, Palliative Care is not just for individuals who are approaching death. Rather, this type of care supports people with a terminal illness, helping them to manage their condition and appreciate quality of life – and it requires different levels or ‘stages’ of care, depending on the stage of their illness.
The moment somebody learns they have a chronic or terminal illness, the 5 stages of Palliative Care stages take immediate effect. Yet the precise stage – and subsequent care – depends on their condition at the time of their prognosis. For example, those in the early stages of a chronic illness might require Palliative Care for many years; and unfortunately, others who receive a terminal prognosis will move quickly to the final stages of Palliative Care.
The 5 Stages of Palliative Care Explained
Stage 1 Palliative Care: Stable
The first stage of Palliative Care is when a patient has received a recent prognosis from a GP that is considered manageable. While in a stable condition, this is the time to create a formal care plan that considers the type of illness or disease, current symptoms and immediate requirements for best quality of life. Additionally, the care team will consider any expected longer-term needs as the illness progresses.
Clients are encouraged to go about their days in the same way as much as possible. Most are able to continue receiving care from the comfort of home and prefer to do so.
Stage 2 Palliative Care: Unstable
When a patient’s condition worsens, or they begin to experience new symptoms, they will need their Palliative Care plan adjusting to accommodate any additional support required. At this stage, they are offered mental support from a psychologist or counsellor to help talk openly about their feelings and prepare for the coming stages. The care team encourages the client to speak with family members about their longer-term wishes, which can be mentally challenging for everyone but a critical part of the process that improves wellbeing.
Stage 3 Palliative Care: Deteriorating
As medical conditions worsen and overall health deteriorates, the Palliative Care team moves their focus (and that of the patient and family) to end-of-life care. Care at home may need adapting to ensure the patient has everything possible to remain comfortable – such as specialist equipment and modifications. All pain-relief medication begins or, if already in place, increases according to the client’s needs.
For some patients, there may only be a short period of life remaining at this third stage, and counsellors provide support to these patients and their families to preserve mental health.
Stage 4 Palliative Care: Terminal
Unfortunately, at this stage, the terminal phase of Palliative Care draws closer, and a client has only days or weeks remaining. The main focus of the Palliative Care team now is to ensure the patient is comfortable. Medical care continues to offer some relief, although additional symptoms can occur and add to the existing pain. A client may become bedridden, lose their appetite or find it difficult to swallow food or medication. Carers provide end-of-life medications and begin servicing any client requests of a religious or spiritual nature.
If the client and family are still to make difficult decisions about what happens after their death – such as where they want to be laid to rest or what to do with their belongings – this is the time to do so.
Stage 5 Palliative Care: Bereavement
By this final Palliative Care stage, the patient has passed on and all focus switches towards their family and loved ones. The Palliative Care team may offer them emotional or psychological directly or through referrals to third parties specialising in bereavement services. Depending on the nature of the patient’s illness and passing on and how it impacted their family or loved ones, Stage 5 Palliative Care may continue for many months, even years.
Palliative Care Stages: Final Words
It is a term often associated with terminal illness, but Palliative Care is just as much for people with a chronic disease who have a longer life expectancy.
Whether chronic or terminal, everybody will progress through the 5 stages of Palliative Care at a different rate. Most notably, if you or a loed one find yourself in the unfortunate position of receiving a life-shortening prognosis, make sure you seek the support of a trusted and dependable Palliative Care provider.
Whether you’re living at home, in a hospital, hospice or care home, Palliative Care can make your condition more manageable – and your life richer in quality.
Vital registered nurses help chronic and terminal illness patients manage symptoms and pain at home. Learn about how a dedicated and structured Palliative Care program can improve quality of life for you or a loved one with a terminal illness.
Vital Home Health Services is led by a team of Registered Nurses with over 20 years’ experience in the public and private health sectors.
If you would like to discuss Palliative Care from Vital or have a question you would like to ask, contact our friendly and helpful team today.
