Palliative Care

Palliative care is the treatment, care and support for people with a life-limiting illness, together with care and support for their family and friends. It’s sometimes called ‘supportive care’.

The aim of palliative care is to help maintain a good quality of life – this includes being as well and active as possible in the time you have left. It can involve:

  • managing physical symptoms such as pain
  • emotional, spiritual and psychological support
  • social care, including help with things like washing, dressing or eating
  • support for your family and friends.

A life-limiting illness is an illness that can’t be cured and that you’re likely to die from. You might hear this type of illness called ‘life-threatening’ or ‘terminal’. People might also use the terms ‘progressive’ (gets worse over time) or ‘advanced’ (is at a serious stage) to describe these illnesses. Examples of life-limiting illnesses include advanced cancer, motor neuron disease (MND) and dementia.

You can receive palliative care at any stage in your illness. Having palliative care doesn’t necessarily mean that you’re likely to die soon – some people receive palliative care for years. You can also have palliative care alongside treatments, therapies and medicines aimed at controlling your illness, such as chemotherapy or radiotherapy.

Palliative care does include caring for people who are nearing the end of life – this is sometimes called end of life care.

End of life care involves treatment, care and support for people who are nearing the end of their life. It’s an important part of palliative care.

It’s for people who are thought to be in the last year of life, but this timeframe can be difficult to predict.

Who provides palliative care?

Many healthcare professionals provide palliative care as part of their jobs. An example is the care you get from your GP or community nurses.

Some people need additional specialist palliative care. This may be provided by consultants trained in palliative medicine, specialist palliative care nurses, or specialist occupational therapists, physiotherapists, social workers or counsellors.

In Devon, there are four main providers of specialist palliative care and end of life care:

Palliative care teams are made up of different healthcare professionals and can co-ordinate the care of people with an incurable illness. As specialists, they also advise other professionals on palliative care.

Macmillan Cancer Support offers advice and practical support for those suffering from cancer and their family/carers.

Six common misconceptions about palliative care

Palliative care is often misunderstood. Here are some common misconceptions about palliative care:

1. If I need palliative care, it means I’ll have to go to a hospice

You can receive palliative care in a range of settings including in your home, a hospital, a care home or a hospice. Most patients receive palliative care in their own home.

2. If I have palliative care, it means my doctors have given up and I’ll no longer receive active treatment for my illness

You can receive palliative care alongside treatments for your illness, such as chemotherapy and radiotherapy. Palliative care can help you cope with these treatments better and improve your quality of life.

3. Having palliative care means I’m going to die soon

You can receive palliative care at any point in your illness. Some people receive palliative care for years, while others will receive care in their last weeks or days.

4. If I have palliative care, I’ll no longer be seen by other specialists who know about my disease

You can receive palliative care alongside care from the specialists who have been treating your illness. Palliative care teams work closely with hospital specialists and will ensure your care is carefully coordinated with any specialists involved.

5. Palliative care is just about treating pain and other physical symptoms

Palliative care aims to provide a holistic approach to give you the best quality of life possible. This means caring for all your physical, emotional, psychological, social and other needs.

6. Palliative care isn’t for family and friends

Palliative care teams are aware that your illness may have a big impact on your family members and friends. Palliative care teams also provide support for those close to you as they understand how important this is to your care and well-being.

When does end of life care begin?

End of life care should begin when you need it and may last a few days, or for months or years.

People in lots of different situations can benefit from end-of-life care. Some of them may be expected to die within the next few hours or days. Others receive end of life care over many months.

People are considered to be approaching the end of life when they are likely to die within the next 12 months, although this is not always possible to predict. This includes people whose death is imminent, as well as people who:

  • have an advanced incurable illness, such as cancer, dementia or motor neurone disease
  • are generally frail and have co-existing conditions that mean they are expected to die within 12 months
  • have existing conditions if they are at risk of dying from a sudden crisis in their condition
  • have a life-threatening acute condition caused by a sudden catastrophic event, such as an accident or stroke

The National Institute for Health and Care Excellence (NICE) has published guidance on the care of dying adults in the last days of life. This guidance covers how to manage common symptoms, as well as dignity and respect for the dying person, their relatives and carers.

Who provides end of life care?

Different health and social care professionals may be involved in end-of-life care, depending on need. For example, hospital doctors and nurses, GP, community nurses, hospice staff and counsellors may all be involved, as well as social care staff, chaplains (of all faiths or none), physiotherapists, occupational therapists or complementary therapists.

If you are being cared for at home or in a care home, your GP has overall responsibility for your care. Community nurses usually visit you at home, and family and friends may be closely involved in caring for you too.

Some people need additional specialist palliative care. This may be provided by consultants trained in palliative medicine, specialist palliative care nurses, or specialist occupational therapists, physiotherapists, social workers or counsellors.

In Devon, there are four main providers of specialist palliative care and end of life care:

The Marie Curie Foundation is an end-of-life charity that provides domiciliary nursing care and support for patient’s nearing end of life.

How do I get palliative or end of life care?

Speak to your GP or other healthcare professional about how palliative or end of life care might help you and how you can access it.

If you’re a family member or friend of the person who is ill, you may be able to access support for yourself. If the person who is ill is receiving care from a hospice or other local service, you may also be able to get support from them. Even if the person who’s ill doesn’t want to have palliative or end of life care, you can still get support. To find out what’s available, speak to your GP, the person’s GP, or another health or social care professional.

Selfcare and more information

For more information about end-of-life care, including making a will, lasting power of attorney (LPA) and advance decision to refuse treatment click here.

For more information about local NHS cancer services in Devon and Cornwall, download the My Sunrise app here. (this app can be downloaded on mobile devices)

For more information regarding providers of specialist palliative care and end of life care, follow the links below:

Waiting for a specialist opinion

If you have been referred for a specialist opinion your details will be reviewed, and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found using the links below.

How long will I wait?

If a hospital assessment and/or treatment is clinically recommended your information will be sent to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.