When facing cancer, advanced organ failure or other serious illnesses, patients may experience pain, breathlessness, nausea, loss of appetite and other symptoms as their condition progresses. These symptoms can affect their daily lives and physical and emotional well-being, in addition to the challenges of managing the illness itself.

Palliative care aims to relieve the physical and psychological burden of illness through professional assessment and appropriate care, helping patients maintain their quality of life and dignity as much as possible. In addition to medication, nursing care, rehabilitation, nutritional support and emotional support are also important components of palliative care.

1. What Is Palliative Care? Does It Mean Giving Up Treatment?

Many people believe that palliative care is only for patients in the final stage of life, or that it means giving up treatment. In fact, palliative care can provide support at different stages of an illness and can be provided alongside other treatments, such as chemotherapy.

The key aims of palliative care include:

• - Physical symptom management: Helping to manage pain, breathlessness, nausea, constipation and other discomforts.
• - Maintaining quality of life: Improving daily comfort and functional ability according to the patient's condition and wishes.
• - Emotional support: Addressing the patient's anxiety, fears and emotional needs when facing illness.
• - Supporting family caregivers: Helping family members understand changes in the patient's condition, care approaches and the professional support available.

Palliative care goes beyond symptom relief. It takes a holistic approach to the patient's needs to develop a care plan that is appropriate for their individual circumstances.

2. How Does Palliative Care Manage Common Symptoms?

Advanced illness can cause a range of symptoms of varying severity. The healthcare team will assess their possible causes and develop an appropriate management plan based on the patient's condition, overall health and goals of care.

Common symptoms and the support available include:

• - Pain: 
• A doctor will assess the pain and prescribe appropriate pain relief, alongside non-pharmacological approaches such as comfortable positioning and relaxation techniques.
• - Breathlessness: 
• Helping the patient adopt a comfortable position, keeping the environment well ventilated, and using appropriate medication as advised by the healthcare team.
• - Constipation, nausea and vomiting: 
• Assessing possible contributing factors, including medication, activity levels and the underlying illness, before arranging appropriate management.
• - Loss of appetite and swallowing difficulties: 
• Adjusting food portions and texture according to the patient's ability to eat and swallow. Assessment by a speech therapist or dietitian may be recommended when necessary.
• - Dry mouth, restlessness and insomnia: 
• Improving the patient's comfort through oral care, environmental adjustments and appropriate emotional support.

It is important that symptoms are assessed individually by the healthcare team. Family members should not adjust prescribed medication without medical advice. If the patient experiences sudden worsening of pain, persistent vomiting or a significant change in consciousness, contact the healthcare team promptly. In an emergency, such as severe breathing difficulties or sudden loss of consciousness, seek emergency medical assistance immediately.

3. How Can Palliative Care Be Provided at Home?

Some patients prefer to receive care in the familiar surroundings of their own homes. If their medical condition and home environment are suitable, they can discuss home palliative care arrangements with their healthcare team, allowing professional care to become part of their daily lives.

Home-based end-of-life care involves more than family members providing care on their own. Depending on the patient's symptoms and needs, it can include professional assessment, an individualised care plan and ongoing follow-up. Support may include:

• - Comprehensive assessment and an individualised care plan: Assessing the patient's overall health, symptoms and care needs, and discussing the findings with the patient, family members and attending doctor.
• - Pain management and medication support: Following the doctor's treatment plan, monitoring medication effectiveness and side effects, and communicating relevant changes to the healthcare team when necessary.
• - Non-pharmacological comfort measures: Using comfortable positioning, body support and relaxation techniques alongside medication to help relieve discomfort.
• - Ongoing monitoring and care adjustments: Observing changes in symptoms and the effectiveness of care, and discussing further arrangements with the healthcare team according to the patient's needs.

The specific arrangements for home palliative care depend on the patient's condition, home environment and available medical support. Not all symptoms can be managed at home. Before arranging home end-of-life care services, the healthcare team should assess the patient's needs and the suitability of the care environment.

4. When Should Palliative Care Be Considered?

When a serious illness continues to affect a patient's daily life, or existing symptom management does not provide sufficient relief, they can discuss palliative care options with their attending doctor.

It may also be helpful to seek professional advice early in the following situations:

• Pain or other symptoms recur frequently and affect sleep or daily activities.
• The patient wishes to recover or remain at home after hospital discharge and requires ongoing nursing care and symptom management.
• The patient or family is uncertain about medication use, changes in symptoms or daily care arrangements.
• The patient wishes to discuss future goals of care and suitable care options in advance.

The aim of palliative care is to relieve discomfort as much as possible at different stages of an illness, ensuring that patients receive appropriate care and support. Through professional assessment, pain management and symptom control, patients can discuss care options that better meet their individual needs with their healthcare team. Those who wish to receive care at home can also contact YDCare to learn more about home palliative care and home-based end-of-life care arrangements.

Read More:

Palliative & End-of-life at Home

Advanced Cancer Care at Home: Daily Support, Palliative Care and End-of-Life Planning

Planning for End-of-Life Care at Home: What Families Should Know