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Five myths about palliative care

Hello Again!

Today I write from a small country town in NSW. Why am I here you ask? I’m visiting relatives on their farm while on annual leave!

I decided after a busy 9 months Grad Year-ing, it was time to step away from the hustle and bustle of the city life and the stresses of nursing to relax and embrace the farm life and boy is it delightful!

After a few weeks of wet weather and floods, the valley has turned on the most beautiful weather for me – 25 degrees and sunny (Melbourne take notes!). But perhaps my favourite part of all is the lifestyle.

Yesterday I spent the afternoon riding a quad bike with my trusty farm dog, I fed poddy calves, donkeys and geese and then returned to the kitchen where my aunt and I made homemade pasta for dinner. This morning I am sitting in the dappled sunlight amongst the beautiful flowers, surrounded by the sounds of birds chirping and cows mooing. With such patchy phone and internet reception on my mobile, I am blissfully uncontactable and enjoying the delights of the country. And the greatest novelty for me is I am being paid to be here!

Prior to this year, I had always been employed casually, so annual leave is a luxury I am experiencing for the first time and I can now see merit in actually taking leave. All year I have been reminded that “you can’t pour from an empty cup” but never really noted that my cup was running low. And while I’ve only been here for 2 days, already I’m sleeping better and can feel the stress dissipating. So whether you are a grad or have been in the field for 5, 10, 20+ years, remember to take leave and refill your cup (even if it is just for a couple of days!).  

But for now, with my new-found clarity of mind, let’s stop and explore a few myths behind palliative care

1. Palliative care means you are dying

There seems to be a wider misconception that palliative care is only offered when death is imminent. However, the palliative care team are experts in symptom management as well as end of life care. Consequently, many of our patients will visit us so we can help formulate a management plan of their symptoms (such as pain and nausea) so they can manage better when they return home and to improve the quality of their remaining life. Many patients return when their symptoms change as their disease progresses so we can review and alter the management plan to ensure they have the best quality of life possible.

2. Palliative care is only available in a hospital setting

Palliative care can be provided in an array of settings including hospitals, specialist palliative care facilities, aged care facilities, hospices and the home. While our unit is an inpatient unit, there are many community services on the Peninsula which provide Palliative Care within the home and community.

3. Palliative care is only for people with cancer/old people

Whilst many of our patients have cancer, by definition, palliative care is the care of someone with a terminal illness and their family. Therefore, anyone diagnosed with a terminal illness from cancer to multiple sclerosis can access palliative care. As no one is exempt from terminal diagnoses, children can also receive palliative care, though Peninsula Health does not provide paediatric palliative care services.

4. Palliative care means no more treatment

When a patient decides to receive palliative care, treatment doesn’t necessarily cease, but rather the goals of treatment shift. The goal of treatment is no longer focused on cure but rather quality of life and comfort. For example, a cancer patient may continue to receive radiotherapy but instead of aiming to cure the cancer, we aim to reduce the size of the tumour that is causing the patient pain and discomfort.

5. Pain is an inevitable part of dying

With the goal of palliative care being quality of life and comfort, our team strive to relieve our patient’s pain to the best of our ability. The palliative team have developed advanced skills in pain management and take pain very seriously. Medications are our primary pain management tool with various tactics to ensure our patients experience as little pain as possible throughout their entire disease progression. Many patients have a regular regime of analgesia with an additional regime of what we call ‘breakthroughs’ which we can administer if and when the pain isn’t managed by the regular doses. These regimes are reviewed daily to ensure the best pain management regime can be reached for the individual patient. If these regimes aren’t sufficient a Continuous Subcutaneous Infusion or Syringe Driver may be commenced which, as the name suggests, continuously administers a small amount of analgesia with the aim of reducing the base line pain threshold. Breakthrough medications will still be available even with these infusions. Every patient experiences pain differently throughout the different stages of their disease progression. Consequently, pain management plans differ from patient to patient, however the goal of reducing pain and eliminating it where possible, remains the same for all.

So there you have it, my take on de-bunking a few of the common palliative care myths. Please feel free to ask further questions and share this with family, friends and colleagues who might benefit from understanding more about palliative care.

Until next time,
Goodbye from the country!