What is palliative care?
The term palliative care describes an approach to care that improves the quality of life of people and their families who are facing the problems associated with a progressive illness. It does this by preventing and relieving suffering through early identification and assessment, by treating pain and other physical, psychosocial and spiritual problems and by addressing practical issues.
Palliative care services provide support to patients with a life-threatening illness through:
- Direct care for patients requiring specialist palliative care interventions, including symptom control and counselling.
- Shared care arrangements with other health care providers and assistance navigating these.
- Consultation and advice to other services and health care teams providing end-of-life care.
- Education and training on palliative care and end-of-life issues.
- Undertaking and disseminating research about caring for the dying and their families/carers.
Who needs palliative care?
People from any age group who are diagnosed with a potentially life-limiting illness may benefit from a palliative approach to care and/or a referral to specialist palliative care services. Examples of life-limiting illnesses include:
- Chronic disease
- End-stage organ failure (chronic heart failure, respiratory disease, kidney failure, chronic liver disease)
- Progressive neurological conditions (dementia, Alzheimer’s disease, multiple sclerosis, Huntington’s disease, motor neurone disease, Parkinson’s disease, major strokes)
When to refer for palliative care?
Palliative care community providers prefer GPs to refer early. This facilitates engagement with the patient and their families/carers, assists them to navigate the health system, and helps provide psychosocial and medical support.
Always ask the ‘surprised’ question: “Would I be surprised if this patient were to die in the next few months, weeks or days?” If your answer is “no” then this should be a prompt for communicating with the patient and their family about ongoing treatment, preferences for care and preferred place of care.
How is palliative care provided?
There are three main ways palliative care is provided in Australia:
- Primary health care providers (also known as generalist palliative care providers)
- A multidisciplinary team that provides the palliative approach (medical, nursing, pharmacy, other allied health)
- Specialist palliative care providers
What services are available in my region?
Community palliative care services are regionalised to Primary Health Network (PHN) and local council boundaries. In the North Western Melbourne Primary Health Network (NWMPHN) region we have four community service providers:
- Banksia (Banyule, Nillumbik and Whittlesea)
- Macedon Ranges (Macedon Ranges Shire)
- Melbourne City Mission (Hume, Moreland, Darebin and Yarra)
- Mercy (western region of Melbourne including City of Melbourne)
In addition, each public hospital has specialist palliative care inpatient and outpatient services.
The statewide services are:
- Peter MacCallum Cancer Centre Palliative Care Specialist Clinic
- St Vincent’s Hospital Melbourne Palliative Care Outpatients Clinic
- Very Special Kids (VSK) Children’s Hospice
- Victorian Paediatric Palliative Care Program
HealthPathways Melbourne provides clinical advice and easy-to-follow maps of referral services. It is the best ‘one-stop-shop’ for information on palliative care services and includes information on all services in our region.
HealthPathways Melbourne has a comprehensive referral page with the name and contact information for private, after hours, community and hospital-based referral options within the NWMPHN region.
If you do not have access to HealthPathways please contact firstname.lastname@example.org
Where can I get more information?
NWMPHN is involved in a project to help empower GPs and other primary care providers through education, linkages and engagement to be able to provide best palliative care. More information is available on our website.
Guides and tools to assist with recognising the last 12 months of life, including the Supportive and Palliative Care Indicators Tool (SPICT) and the Gold Standards Prognostic Indicator Guidance are available on the health.vic website.
Disclaimer: This article was provided by Dr Jeannie Knapp. While every effort has been made to ensure the information is accurate, North Western Melbourne Primary Health Network does not warrant or represent the accuracy, currency and completeness of any information or material included within.