Palliative care aims to promote quality of life and comfort for patients facing serious illnesses. It provides relief from pain and other distressing symptoms, and addresses patients' physical, psychological, social, and spiritual needs. A multidisciplinary team works to help patients live as actively as possible until death, and also supports families during illness and bereavement. Key members include physicians, nurses, social workers, chaplains, and dietitians. The goals are to assess symptoms, discuss prognosis, understand patient values and goals, and ensure support systems are in place.

1. M.Sc. Nursing
MRS. VAISHALI JADHAV

2. DEFINITION
 WHO
The active total care of patients whose disease is not
responsive to curative treatment. Control of pain, of
other symptoms, and of psychological, social and
spiritual problems is paramount

3. Palliative care
Palliative care --- affirms life & regards
dying as a normal process--- neither
hastens nor postpones death– provides
relief from pain & other distressing
symptoms, --- integrates the
psychological & spiritual aspects of
care– offers a support system to help
patients live as actively as possible until
death,--- offers a support system to help
the family cope during the patients
illness & their own bereavement.

4. Goal
 To promote quality of life and
comfort.

5. Principles
 Patients & family are the unit of care
 Attention to physical, psychological, social &
spiritual needs
 Multi-professional team work
 Evaluation of care
 24 hours , 7 days a week availability
 Support during bereavement

6.  Education & teaching
 Therapeutic physical environment
 Care of patient with nonmalignant conditions
 Supportive administration
 Preparedness for the cost of care

7. Members of palliative care-
multidisciplinary team
 Physician
 Nurse
 Social worker
 Chaplain
 Dietitian
 Volunteers
 Other disciplines

8. Elements of palliative care assessment
 Distress from physical symptoms
 Patients goals
 Psychological & spiritual assessment
 Discussion of prognosis
 Support systems & wishes for end of life care

9. Distress from physical symptoms. Ask
patients:
 What is their understanding of the
cause of the symptom?
 What is their goal of relief?
 What are current side effects?

10. Patients goals. consider
 What is important to the patient?
 How can we help the patient ‘live well’ in the days
ahead?
 What personal goals does the patient have that
healthcare team members should take in to
considerations?

11. Psychological and spiritual assessment
 Elicit information about how the patient has coped
with stressful situations in the past.
 Who does the patient turn to for support?

12. Discussion of prognosis. Consider:
 What is the patient’s functional status?
 Is there major organ failure?
 Are multiple symptoms present?

13. Support systems & wishes for end- of life
care. Consider:
 Where does the patient want to be at the time of
death?
 Who is available to assist?
 What are the capabilities of the caregiver in
relationship to the complexity of symptom
management needs?

14. Symptom control in palliative care
 Radiotherapy
 Surgery - Tracheostomy
Gastrotomy/ jejunostomy
Colostomy
 Chemotherapy

15. Symptoms commonly encountered in
palliative care
 Pain
 Constipation
 Nausea & vomiting
 Intestinal obstruction
 Pruritis
 Hiccups
 Cough
 Dyspnea