Palliative Care Week
From the 19 May – 25 May, Australia will celebrate the 2013 National Palliative Care Week. Palliative care will affect many people at some point in their lives. To ensure everyone has access to quality care at the end of life, it is a national priority that Australia takes responsibility that this happens.
In response, the Australian Government has launched the National Palliative Care Program which aims to provide and improve the standard of palliative care available to the Australian community through a $14 million investment over four years. There has also been an investment of over $500 million to the nations States and Territories to provide for enhancements of care services, including palliative care.
What is Palliative Care?
Palliative care is concerned with support for terminal illness. Where an illness cannot be cured, palliative care is required to ensure the patient can then have access to the best quality of life. Palliative care nursing can also involve the care needed to support parties such as family and caregivers. Palliative care nursing can involve the maintenance of physical symptoms such as pain as well as addressing and fulfilling patient’s emotional, spiritual and social needs.
Palliative care aims to:
• Affirm life
• Follow the process of death and treat dying as a normal process
• Act as a pain reliever (both physical and emotional)
• Support people to live actively until death
• Support the patient’s family with the palliative care process
Who Receives Palliative Care?
Palliative care is a type of care administered to people of any age who are dying. While there is no set criteria for being a palliative care patient, clients usually have a conditions which may include, cancer, motor neurone disease, HIV/AIDS, multiple sclerosis, end-stage dementia and muscular dystrophy.
Who Provides Palliative Care Nursing?
Palliative care nursing involves many health and care professionals. They can include:
• Specialist doctors, medical and nursing staff who have completed study and have experience in the area
• General practitioners and other general medical staff working within the health care field
• Nurses
• Support services like grief and bereavement counselors
• Allied health professionals, pharmacists, occupational therapists, physiotherapists
• Social workers
• Pastoral care workers
Where is Palliative Care Provided?
There are a number of locations palliative care nursing is provided. It can range from being in a client’s private home, to a community area like a hospice, respite centre, nursing home, hospital or palliative care unit.
When choosing a palliative care facility there are many contributing factors to the decision, including geography, services currently available in the location, both family and friend preferences, the needs of the client, the nature of the illness, the support available from the clients family home and community and the availability of family carers.
Palliative Care and the Certificate III in Aged Care
During Inspire’s Aged Care Course, students are required to complete CHCPA301B Deliver Care Services Using A Palliative Approach. The unit is designed to prepare students for working with clients who have a life-limiting illness and/or normal ageing process by equipping them with the knowledge, skills and value required to administer a palliative care nursing approach. Students will focus on five elements throughout the unit, including:
Palliative Care Element 1: Apply a palliative approach
• Differentiate between practices applicable in curative and palliative approaches
• Apply the principles and aims of a palliative approach in caring for clients
• Use an approach that reflects an understanding of the client’s needs as holistic and extending over time, not just end-of-life
Palliative Care Element 2: Respect the client preferences for quality of life choices
• Encourage client, carers, family members and/or significant others to share information regarding changing needs and preferences through a supportive environment
• Respect client’s lifestyle, social context and spiritual needs and document observations in line with care plan
• Respect cultural choices in line with care plan
• Support the freedom of the client, carer, his/her family and /or significant others to discuss spiritual and cultural issues in an open and non-judgemental way within scope of own responsibilities and skills
• Refer further needs and issues to appropriate member of the care team in line with organisation protocols
• Provide emotional support using effective communication skills
• Demonstrate respect for the relationship between the client and carer
Palliative Care Element 3: Follow the client’s advanced care directives in the care plan
• Work in a manner reflecting understanding and acceptance of the legal and ethical implications of the need to follow advanced care directives
• Consistently follow advanced care directives in the care plan in line with own work role
• Comply with end-of-life decisions as documented in the care plan and in keeping with legal requirements
• Report the client’s needs/issues in relation to end-of-life to the appropriate team member for documentation in the care plan
• Recognise impact of client’s end-of-life needs/issues on carers and refer to appropriate member of the care team in line with organisation protocols
• Deliver services in a manner that supports the right of clients to choose the location of their end of life care
Palliative Care Element 4: Follow end-of-life care strategies
• Regularly check for any changes on care plan that indicate decisions made by client have been reviewed
• Provide supportive environment to client, families, carers and those involved in their care at end-of life
• Consider client’s preferences and culture when providing end-of-life care according to care plan
• Maintain dignity of the client in undertaking planned end-of-life care and immediately following death
• Recognise any signs of client’s imminent death/deterioration and report to appropriate member of care team in line with organisation requirements
• Recognise emotional needs of other clients, carers and their families affected and provide support when a death has occurred
Palliative Care Element 5: Respond to signs of pain and other symptoms/discomfort
• Observe client closely and identify pain and other symptoms in line with care plan directives
• Document observations of pain and other symptoms and promptly report to appropriate member of care team
• Implement strategies to promote comfort in line with care plan
• Regularly evaluate and document effectiveness of implemented strategies
• Refer to appropriate member of staff any misconceptions in the workplace surrounding the use of pain relieving medication
Palliative Care Element 6: Manage own emotional responses and ethical issues
• Identify and reflect upon own emotional responses to death and dying and raise and discuss any issues with supervisor or other appropriate person
• Acknowledge potential impact of personal responses on self and others and action appropriately
• Accept need for bereavement care and support of other team members
• Reflect upon ethical issues and discuss with appropriate person if necessary
• Follow organisation policies and procedures in relation to managing emotional responses and ethical issues
