Palliative care is specialized medical care for people with serious illnesses. It focuses on providing relief from the pain, symptoms and distress of serious illness. It is a team-based approach to care involving specialty-trained doctors, nurses, social workers and other specialists focused on improving quality of life. By determining patients’ goals of care through skilled communication, treating distressing symptoms and coordinating care, palliative care teams meet patients’ needs and help them avoid unwanted and expensive crisis care. Unlike hospice care, palliative care can be provided at the same time as curative treatments; it is appropriate at any age and at any state of a serious illness.
- Somatic, visceral, neuropathic
- Fatigue-Fatigue disproportionate for level of activity or not relieved by rest
- Respiratory – Dyspnoea, cough, oropharyngeal secretions
- Gastrointestinal – Anorexia, nausea, vomiting, constipation
- CNS – Insomnia, confusion, delirium, anxiety, depression
- Other – Functional status, balance problems, oedema, wound problems, cancer, CHF, COPD, kidney failure, Alzheier’s, Parkinson’s, ALS and many more.
When Should The Assessment Take Place?
Assessment should be an ongoing process throughout the course of a patient’s illness. We suggest that assessments be carried out at key transition points in the patient pathway, for example:
- at diagnosis of a life-limiting condition
- at episodes of significant progression/exacerbation of disease
- a significant change in the patient’s family/social support
- a significant change in functional status
- at patient or family request
- at end of life