The National Council for Palliative Care in the UK defines palliative care as follows:
- Affirms life and regards dying as a normal process;
- Provides relief from pain and other symptoms;
- 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 patient’s illness and in their own environment.
In the UK, palliative care can be offered in the patient’s own home, in a hospice (residential or day patient) or in hospital. Most palliative care is provided in a hospice. However, if a patient decides to stay at home during the terminal phase of their illness, their GP or consultant can arrange for community palliative care nurses, such as Macmillan (http://www.macmillan.org.uk) or Marie Curie (http://www.mariecurie.org.uk) nurses, to provide care at home. The social services department may need to be contacted to provide a range of social care services and equipment to help terminally ill people remain at home.
Specialist palliative care teams, such as the Macmillan support team or symptom control team, can be called upon to provide palliation in a hospital setting. These teams may be comprised of doctors, nurses, physiotherapists, dieticians, social workers and chaplains, or the service can be provided by a single nurse. The service provides education, training and specialist advice on pain and symptom management to hospital staff. They advise staff on the patient’s discharge plan or transfer to a hospice, community hospital or care home. They also provide emotional support directly to patients and carers.
The importance of a multi-disciplinary approach cannot be over-stressed. No patient with palliative care needs should be denied the expertise of a specialist palliative care service. Close working relationships between the uro-oncology team and the palliative care team can only enhance the palliation of renal cancer. Likewise, physiotherapists and occupational therapists have a very large part to play in symptom management and maximising independence.
Reference
The National Council for Palliative Care (2017) : http://www.ncpc.org.uk/palliative-care-explained (accessed 14 September 2017)