A palliative approach to care maintains the quality of life for older people who have a disease or illness that cannot be cured or who are becoming frail. It supports quality of life by planning and addressing needs as they arise. In older populations people with dementia will be more common. This needs to be considered when providing a palliative approach to care.
A palliative approach looks at:
- Early identification of the palliative phase.
- Assessment of current and future needs.
- Treatment of pain.
- Addressing physical, cultural, psychological, social and spiritual needs.
Aboriginal and Torres Islander people have poorer health and higher rates of disability than non-Indigenous people.
For this reason, Aboriginal and Torres Strait Islander people aged 50 years and over are included in aged care planning, as distinct from 65 years and over for non-Indigenous people.
The palliative approach to care promotes safe and quality care that can reduce distress and manage pain and other symptoms in a timely way. This approach involves the older person and their family in decision making. It also recognises and values nursing skills in caring for older people with a life-limiting illness.
Nurses will frequently be the main healthcare professional contact for an older person who has palliative care needs.
Nurses can provide a palliative approach to care by:
- Establishing who the older person under their care would like to speak for them if they become unable to make decisions for themselves.
- Helping the older person express their values and beliefs about quality of life and what “living well” means to them.
- Providing older people with the opportunity to participate in Advance Care Planning (ACP) as well as ensure that older people who choose not to undertake ACP have their wishes respected, too.
- Playing an active role in making sure that information about the older person is communicated to authorised members of the healthcare team, and
- Identifying changes in the older person which require assessment and addressing of symptoms.
Sometimes more expert care will be needed. Specialist palliative care professionals can provide advice on complex issues to support nurses who are engaged in using the palliative approach. This specialist care will be focused, intermittent and specific to what is required. It does not usually take over the regular palliative care management of the older person.
Referral to a specialist palliative care team could be considered when assessing and treating complex symptoms, managing complex family dynamics or dealing with other complex issues (including ethical dilemmas).
Discuss the possible need for referral with the person’s GP. Referral is usually done by a health professional. Remember to check that the person is willing to be seen by a palliative care service.
Page updated 23 May 2017