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When should I consider Palliative Care for a patient?

Palliative care can begin from the first diagnosis of a life limiting illness.

It can be provided in tandem with treatment to manage complex pain and other physical and psycho-social symptoms with the goals of increased patient comfort and improved quality of life for the patient and their family. There are also clinical triggers for referral to palliative care for chronic conditions such as poor symptom control, frequent exacerbations and/or admissions to hospital.

##Where symptoms or distress do not respond to initial management, consider early referral to specialist palliative care services.

##The GP has an essential role in relation to specialist palliative care services. However their contribution may be limited by being part-time, or by other practice-related factors. Clarification of the care processes for each patient is therefore critical, including who has responsibility for: ##Maintaining prescriptions for palliative medications

##Regularly reviewing patients’ symptoms, and assessing their care arrangements

##Either being available or ensuring availability of home visiting for patients who are no longer able to attend a GP clinic

##Being available to write a death certificate for patients who wish to die at home.

No, palliative care is also beneficial for people with advanced heart, lung, renal and liver disease and conditions such as Motor Neurone Disease, advanced dementia, AIDs, and other conditions where their death within the next 12 months would not be a surprise. A referral to specialist palliative is desirable if there are complex symptoms or psycho-social issues that require specialised expertise.

Specialist palliative care health professionals include medical, nursing, and a broad range of allied health and other staff. They are an inter-disciplinary team that uses a person and family-centred approach to provide holistic palliative care and end of life care. They can assist other health professionals involved in the care of the patient and family by providing consultancy advice and specialised expertise, care and support. Areas of specialised expertise include: pain and symptom assessment and management, communication and advance care planning, and coping with loss, grief and bereavement.

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