eTG's Palliative Care 4

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The Palliative Care guidelines have been extensively revised by the expert writing group for this edition. A number of new topics have been included to provide holistic advice on the principles of palliative care, and detail on specific symptom management at the end of life. The guidelines highlight that a palliative approach to care can be adopted by any healthcare provider and applied to any patient with life-limiting illness, including those with malignant or nonmalignant conditions.

An overview of palliative care describes how to identify patients at risk of deteriorating and dying, and the benefits of early introduction of a palliative approach to care. The importance of advance care planning is emphasised, with practical advice on advance care planning conversations, documentation, and communication of an advance care plan. There is also new guidance on discussing prognosis with a patient.

More detail on decision-making and ethical challenges in palliative care is provided, including the ethical aspects of withdrawing or withholding treatment. Ceasing medical interventions such as noninvasive ventilation and renal dialysis, and turning off implantable cardiac devices, are considered for patients with life-limiting illnesses other than cancer. Information on prognostication and symptom management is also included for this group of patients.

The principles of paediatric palliative care are discussed in more detail, particularly considering advance care planning for children, ethical issues and decision-making, and the importance of good communication.

New information is included on supporting families and carers, recognising the importance of the caregiving role, the impact on carers, and how to support families and carers. There is specific advice about bereavement support for adults, children, and families after the death of someone close. There is also advice for families about children visiting a person who is dying.

last updated: 
Wednesday, 7 September, 2016