Palliative nursing care involves supporting people who are in their final few weeks, months or years of their life. It impacts on people approaching very old age and those living with a progressive or terminal disease or condition. Some of the more common conditions and diseases that can involve a period of palliative care include cancer, cardiovascular diseases, chronic respiratory conditions, AIDS and end-stage diabetes and neurological conditions.
The purpose of palliative nursing care is to make the person as comfortable as possible during the final stage or stages of their life, and to help the dying person with dignity and in as little pain as possible. While it is a very sad time for those involved, if end of life care is administered correctly, it can also be a peaceful stage to go through.
Palliative nursing care can carry on alongside other medical treatments, such as radiotherapy or chemotherapy. It is not a sign that the person or their doctors are ready to give up on treating their condition or disease. Often, it can help regular treatments, as the person feels more comfortable and supported for the care services they get. This can lead on to their mental health improving and motivation increasing to continue with other treatments, dietary regimes or supplementary therapies.
It is especially important to ask the patient their wishes regarding palliative care, and to follow them as closely as possible. Choices include how they would like to spend the time they have left, where they would like to die and which people they would like to be present. End of life care can be administered in:
1· Hospital
2· Hospice
3· Residential care home, or
4· In the person’s own home
Palliative nursing care normally involves palliative care teams of medical and other professionals, including doctors, care nurses, residential care home staff, occupational therapists, counsellors, social care staff and chaplains from a relevant religion or faith.
Friends and family members can often be involved too, according to the patient’s preferences and support networks. Support can come from the NHS or private sources, depending on the patient’s wishes and resources.
Additionally, palliative nursing care can involve varying levels of social health care support. This could include help with:
1· Washing and dressing
2· Eating and drinking
3· Retaining communications with loved ones, and
4· Offering legal and financial advice.
If the patient is in a residential care home, they should expect privacy and dignity in how their care is managed. They should be in a private room and receive support in tasks such as toileting, dressing and eating with discretion and respect.
Palliative care is often described as taking an holistic approach. This means that the loved one is cared for as the individual and complex person they are, rather than a set of textbook medical symptoms. They will have their needs met from a number of considerations. Painful or distressing symptoms will be managed as well as possible and medication given to help the person feel comfortable. This offers reassurance both to them and their loved ones who don’t want to see them suffer needlessly.
The patient and family along with friends should also expect good quality psychological, emotional and practical support from professionals and support workers during palliative nursing care. It is important to note that, even if someone facing a terminal illness or reaching their end of life stage does not want certain aspects of palliative care support, this can still be made available to their loved ones. This can include religious or faith-based support, legal advice or input from a social worker or other relevant professional.
That said, while the patient has the capacity and desire to make their own decisions and has not activated any arrangements, such as Power of Attorney, this will be fully supported by medical staff and is a right protected by law. After the person has passed away, palliative care can also include providing services to friends and family members, such as bereavement counselling and support with making funeral arrangements.
There is plenty of information online for relatives and friends about the processes involved in palliative and end of life care. This includes detailed guidance from the National Institute for Health and Care Excellence (NICE).
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