What is palliative care?

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. The World Health Organisation.

Palliative care acknowledges that you as the patient are first, and foremost, a person and that when you live with a life limiting illness you can experience suffering on a very personal and individual level. It also acknowledges that you are part of a family/whānau that will be living this experience with you. Palliative care practitioners are trained to assess your condition, symptoms, concerns and uncertainties and then work with you and your family to provide the best possible relief of suffering, whether it is physical, emotional or spiritual.

When is palliative care helpful?

Palliative care can be helpful in all stages of serious illness; it may be called upon earlier to support you through the diagnosis of a life limiting diagnosis, interventions and therapies aimed at controlling your illness such as chemotherapy, surgery, radiotherapy, renal dialysis. Wherever your illness causes distress, be it physical, emotional or spiritual, palliative care can be available to reduce the impact on you and your family. It can provide direct input, advice, support and recommendations to relieve the suffering associated with symptoms, concerns, fears, you or your family may have.

Palliative care is also helpful in supporting colleagues who may be more directly responsible for your care such as those in community primary care e.g. your GP or those that are hospital based e.g. renal teams, oncologists, surgical teams.

Who provides palliative care?

Because palliative care is applicable in all stages of serious illness, specialist palliative care teams are present in the hospitals and the community through hospice organisations. Palliative care is also provided by GP teams, district nurses and aged residential care staff.

Within the hospitals and Te Whatu Ora provided services, the Hospital Palliative Care Team is available as a consult service to work closely with the team directly responsible for your care and treatment in the hospital. It then liaises with the community palliative care services so your care can be handed over and transitioned in the smoothest way possible. Your care may therefore be transitioned to an inpatient bed in one of the hospices or back home, where support can be provided through different agencies including hospices. Your care may also be transferred to an aged care setting where specialist palliative care support also remains available to you, your family and the staff taking care of you. The Hospital Palliative Care Team will ensure the appropriate referral and discharge information, including medications, is available to those who receive direct responsibility for your care.

The hospices in the Waitematā region are:

Hospice North Harbour

• North Shore, Takapuna: phone (09) 486-1688
• Hibiscus Hospice, Red Beach: phone (09) 421-9180
• Warkworth Wellsford Hospice: phone (09) 425-9535

Hospice West Auckland, Te Atatū Peninsula: phone (09) 834-9750

How can specialist palliative care help when you are in hospital?

The Hospital Palliative Care Team can provide relief, comfort, information and expertise in a number of different ways, including:

• Treatment of pain and other symptoms (such as nausea and/or vomiting, breathing difficulties and sleeping problems) to improve your comfort
• Emotional and spiritual support for you and your family/ whānau. Serious illness can be frightening and sad; sometimes thoughts and feelings are troublesome. Having someone to talk with can often make a major difference
• Information about medications and treatments and the reason they are used
• Guidance and support with decisions and choices about treatment and care which may be difficult or confusing when you have a life-threatening illness. They may help facilitate conversations around Advanced Care Planning
• Help with understanding the healthcare system, which can be confusing and overwhelming especially if you are under the care of several different teams
• Help with co-ordinating care at home and in the community
• Support with end-of-life issues. When death is close it is important that your care in hospital is focused on keeping you comfortable and meeting the needs and wishes of you and your family/ whānau
• Along with social work services, the Hospital Palliative Care Team can provide support with worrying areas such as finances, work, or relationship problems to both find solutions and resolve concerns.

How does the Hospital Palliative Care Team become involved in your care while you are in hospital? Team members are able to see inpatients at North Shore and Waitakere hospitals. The Hospital Palliative Care Team is available Mondays to Fridays from 8am to 4.30pm (excluding public holidays).

With your consent, your hospital/ward team sends a referral to the team who will come and visit you on the hospital ward as soon as this is possible. You may ask to see someone from the Hospital Palliative Care Team; your ward team or nurse can arrange a referral.

Your admission to hospital may also be alerted to the team by your GP or hospice staff; a referral to the Hospital Palliative Care Team can then be made with your consent and in agreement with the medical or surgical team responsible for your care while in hospital.