Treatment and care towards the end of life
Treatment and care options
Palliative care is available to anyone, regardless of age, culture, background, or beliefs.
There are many types of care and support options available to assist patients, family members and carers through all stages of a life-limiting illness.
The type of care and support at the end of life will depend on your needs and may include:
- specialist palliative care services
- medical reviews, assessments, scans and blood tests
- medications and procedures
- relief of pain or symptoms
- in-home nursing
- advance care planning
- short-term care relief and respite care
- counselling and emotional support
- cultural and spiritual support
- guidance and help with getting information and resources
- getting equipment needed to aid care at home
- home care services, such as cleaning, meals and home maintenance
- linking to financial assistance services
- bereavement support for family and carers after the patient's death.
Planning ahead while you can, ensures your values, beliefs and preferences are made known before you cannot communicate them or make decisions.
Find out more about creating an advance care plan.
Physical symptoms
Symptoms are what you feel that can show you are unwell. Symptoms may be things like pain, vomiting, loss of appetite and high fever.
Managing symptoms, including pain, is an important aspect of palliative care. As an illness progresses, symptoms may change or increase.
A symptom like breathlessness from end-stage lung disease may not be curable, but it can be managed to ensure comfort and easier breathing.
Some symptoms, like infections, can be completely reversed; however, they may require invasive treatment such as intravenous cannula, which may require going to hospital or an outpatient clinic.
It’s often not possible to know exactly what symptoms a person will have. Talking with the healthcare team about what symptoms to expect, and how to manage them, will help with making a plan.
Some questions to ask your healthcare team include:
- What symptoms are expected in the future (for example, pain or discomfort, constipation, shortness of breath, nausea or feeling sick, lack of appetite, tiredness, dry mouth)?
- What can be done to improve symptoms?
- Do others with the same condition have similar symptoms?
- What is causing the symptoms?
- Will pain and other symptoms be looked after in the future?
- What are the worst days going to be like?
- What are the best days going to be like?
Pain management
Pain is an unpleasant sensation that affects physical, psychological, emotional, and spiritual aspects of life.
Not everyone with a life-limiting illness experiences pain, but for those who do, it is essential to manage it effectively.
When discussing pain management with the healthcare team, consider asking:
- Can you help control my pain?
- Will my pain get worse, if so, when?
- What are the options for controlling my pain?
- Will my body get used to pain relief like morphine?
- Will morphine still be effective in the future?
- Are pain medications addictive?
- How will pain medications affect my mind and thinking?
- Will stronger pain medication, like morphine, make me confused or tired?
- What other symptoms might I expect from strong pain medications?
- Can I alternate between different types of pain medications?
- Are there different ways of taking medications like morphine?
- What alternatives to strong pain medication are available?
- Will pain medications affect other medications I am taking?
- Will my healthcare team support complementary or alternative therapies for pain?
- What other strategies can I use to manage pain?
- If I have pain, does it mean my illness is getting worse?
- If I need pain medication like morphine, does it mean I am dying?
- Would it help to see a physiotherapist or occupational therapist to manage pain and stay active?
Medications
Types of medications most commonly used in palliative care:
- analgesics (to treat pain)
- antiemetics (to treat and prevent nausea and vomiting)
- laxatives / aperients (to treat and prevent constipation)
- adjuvant medications (medications that work with analgesics to improve pain or symptom control)
- steroids (may reduce a range of symptoms related to inflammation)
- antidepressants (to treat depression, or sometimes pain) and other neuroleptic medications (to treat depression, anxiety, or pain delirium)
- sedatives (to help with calmness or sleep)
Questions to consider asking the doctor, pharmacist or nurse about your medications:
- What are all my tablets for?
- What happens if I stop taking any of my medications?
- What are the side effects of any new medication you prescribe?
- How likely is it that I will get these side effects?
- What can be done about side effects?
- Will my new medication affect any current medications or other medical conditions I have?
- Are there any tablets or treatments I should NOT have while taking the new medication?
- What is the cost of the new medication?
- Can I get the new medication from my local pharmacy, or do I have to return to the hospital for each script?
- Are all my old medications still necessary?
- How and when should I take all my medications?
- Are there any complementary therapies that might help?
- Will taking this medication mean I need to spend more time in hospital or outpatient clinics?
- If my palliative treatment is making me feel unwell and not helping to control my cancer, can I choose to stop it?
Costs
Many medications used in palliative care are subsidised by the Australian Government as part of the Pharmaceutical Benefits Scheme (PBS).
You may be entitled to further subsidies if you hold any of the following concession cards:
- Australian Seniors Health Card
- Health Care Card
- Pensioner Concession Card
- Department of Veterans' Affairs (DVA) Gold, Orange or White Card
If you cannot afford the cost of your medication, talk to your doctor or pharmacist for options.
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