Palliative care - general issues: Summary

    Palliative care is defined as the active holistic care of people with advanced, progressive illness.
    Professionals providing general palliative care services should:
        Be involved as early as possible after diagnosis.
        Aim to meet the needs of the patient and their family within the limits of their knowledge and competence.
        Seek specialist advice or refer the patient to specialist services, when necessary.
    During the course of the illness, the patient's needs as well as the needs of their family or carers, should be assessed (and managed) at key points (e.g. at the time of diagnosis, around treatment episodes, as treatments end, at the time of a relapse, and when death is approaching). This includes assessing and managing:
        Preferred care setting.
        Anticipatory prescribing.
        Managing common physical symptoms such as nausea and vomiting or breathlessness.
        Psychological needs.
        Social needs (e.g. help with personal care, housework, and shopping).
        The needs of the family and carers.
    An attempt should be made to estimate the patient's prognosis so that appropriate adjustments can be made to care in the terminal phase.
        The terminal phase may last hours to several days.
        People are likely to be in the terminal phase of their illness when they show certain signs including deteriorating day by day or faster because of their underlying condition, and/or expressing a realization that they are dying.
    Effective communication (verbal and written) with the patient, their carers, and other healthcare professionals is very important including an individualised care plan.
        The patient should be given the opportunity to discuss topics important to them (e.g. advance care planning issues and estimated prognosis).
        Emergency contact numbers and information on what to do when death occurs should be provided to family and carers.
    Care of people with advanced cancer:
        Should be based on locally agreed protocols and guidelines, delivered within the context of a managed system or pathway.
        Requires a multidisciplinary team because of the potential multidimensional nature of problems in palliative care.
https://cks.nice.org.uk/topics/palliative-care-general-issues/