What is Palliative Care?
Palliative care supports people and their families who are dealing with life-limiting illness and helps them to live as comfortably as possible. By 'life-limiting' we mean those conditions that cannot be cured and will at some point result in the person dying, be that years, months, weeks or days away. For instance: cancers that cannot be cured though may still be responsive to drugs or radiation; nervous system, heart, lung or kidney diseases that get progressively more debilitating despite all treatments.

A palliative care approach aims to improve quality of life by addressing social, psychological and spiritual needs as well as physical needs such as managing pain and other distressing symptoms. Palliative Care in the Acute Environment. 

When is Palliative Care helpful?
Palliative care can be helpful at all stages of life-limiting illness. It is often best introduced early on – sometimes even at the point of diagnosis.  It can be helpful at any time, even when someone is having intensive treatments, for instance chemotherapy for cancer, or renal dialysis for kidney failure. In other words, palliative care could be there to provide support, help and comfort to patients and families in those times when illness can be causing major problems or distress. It should also be available wherever the person with life-limiting illness may be – home, hospital (public/private), or rest home. 

Palliative care is best delivered through an integrated approach to care that recognises the roles and responsibilities of both primary providers of palliative care, such as General Practice teams, and other hospital based specialists; as well as specialist palliative care providers in meeting palliative care need.  This integrated model or framework of care delivery is essential for effective palliative care provision.

What is the difference between Primary/Generalist and Specialist Palliative Care?
Primary/Generalist palliative care is palliative care provided for those affected by life-limiting illness as an integral part of standard clinical practice by any healthcare professional who is not part of a specialist palliative care team.  It is provided in the community by general practice teams, Māori health providers, allied health teams, district nurses, and residential care staff etc.  It is provided in hospitals by general ward staff, as well as disease specific teams - for instance oncology, respiratory, renal and cardiac teams.

Specialist palliative care is palliative care provided by those who have undergone specific training and/or accreditation in palliative care/medicine, working in the context of an expert interdisciplinary team of palliative care health professionals, both in hospitals and hospices.

Who provides Palliative Care for you when you are living at home or in a private Resthome or private Hospital? 
General Practitioners and District Nurses all have knowledge of, and ability to provide, palliative care. In CMDHB we have a shared care agreement, whereby Hospice Nurses and District Nurses work together, alongside the GP, caring for and supporting people living in the community. 

In Counties Manukau there are two hospices, Totara Hospice South Auckland in Manurewa and Franklin Hospice based in Pukekohe.  Each provides services to the people living in their locality.

How can Specialist Palliative Care help when you are in hospital? 
The Hospital Specialist Palliative Care Team can often help out and offer you and your family support, relief, comfort, information and expertise in many different situations. These might include:

• Times when your illness is causing discomfort, for example bothersome pain or shortness of breath, or nausea and vomiting. We may be able to help ease these symptoms and improve your comfort.
• Periods when your thoughts and feelings are distressing. Having someone to talk with can often make a major difference.
• Occasions when your illness may be having a big impact elsewhere in your life – maybe with your partner, children, work or perhaps financial affairs. Professional support and advice in these situations can often help you find solutions and resolve some of your concerns.
• You may also be faced with decisions and choices that are confusing or difficult to make during your illness. The Palliative Care Team may be able to help explain things to you and help you find answers that you feel most comfortable with.
• On leaving hospital you may need ongoing support and care. The Palliative Care Team is often able to link in with the right services for you.
• We also recognise that sometimes nature is stronger than any medical treatments we have on offer. When this happens and death is close, it is extremely important that you get the care in hospital that will support you and your family, meet your wishes and needs, and also keep you comfortable. The Palliative Care Team may be involved in your care during these times too.

The current Middlemore Palliative Care Team:-

• Dr Jen Dawson (Palliative Care Consultant) - Acting Clinical Head
• Dr Oleg Kiriaev (Palliative Care Consultant)
• Dr Henna Ansari (Palliative Care Consultant)
• Dr Brian Ensor (Palliative Care Consultant)

• Palliative Care Registrar (Rotation 6 monthly)

• Nardia Scott (Palliative Care Nurse Specialist)

• Kate Dupper (Palliative Care Nurse Specialist)

• Shaku Prasad (Palliative Care Nurse Specialist)

• Adrienne Batterton (Palliative Care Nurse Specialist)

• Margaret Lauese (Palliative Care Specialty Nurse)