Read on Twitter
Usually best to avoid labelling anyone as “being palliative” or having “palliative cancer/heart failure etc.”
The approach to their management may adopt a palliative philosophy but it is not an umbrella term and may lead to under treatment and distress in some situations
The approach to their management may adopt a palliative philosophy but it is not an umbrella term and may lead to under treatment and distress in some situations
A palliative approach still includes reversing the reversible when possible within the context of the patients wishes.
Blood transfusions, antibiotics, fluids, physiotherapy, radiotherapy and management of pre-existing medical conditions can all form part of palliative care.
Blood transfusions, antibiotics, fluids, physiotherapy, radiotherapy and management of pre-existing medical conditions can all form part of palliative care.
It’s important to discuss with patient’s their views on such treatments in the context of their illness and personal beliefs. Dicussion in advance doesn’t mean any decision is final, care plans need review and can change when the time comes.
When referring a patient to a hospice or any non-acute setting it is good practice to cover what the new setting can and cannot offer in terms of medical treatments. This can sometimes determine a person’s preffered place of care and death.
Asking if a patient would wish re-admission to an acute hospital when they are in the last weeks-months of their life is a useful way to explore this. Again any view is not final, admission for management of a hip fracture is a good example of a potentially beneficial admission.
The term “palliative” may indicate a person is no longer fit for a particular treatment such as surgery or chemotherapy. It does not mean that person is not fit for any treatments and it shouldn’t be presumed that the patient doesn’t wish to discuss this with your team.
Aiming to have generalists able to provide good quality palliative care coupled with palliative care specialists able to recognise and treat the reversible when appropriate could provide a perfect balance for delivering end of life care.
