Your palliative care team will be made up of medical, nursing and allied health workers who offer a range of services to assist you, your family and carers throughout your illness, whether you are being cared for at home or in another setting.
Some roles overlap and assistance varies across Australia, but the most common health professionals are listed below. You won’t necessarily see all these people – your family doctor, nurse or palliative care specialist can help you work out which services will benefit you most.
- Generalpractitioner (GP) or family doctor
- Palliative care specialist or physician
- Counsellor or psychologist
- Pastoral carer or spiritual adviser
- Social worker
- Occupational therapist or physiotherapist
General practitioner (GP) or family doctor
- continues to see you for day-to-day health care issues if you are being cared for at home (and may be able to make home visits)
- liaises with your nurse and/or palliative care specialist about the coordination of your ongoing care
- refers you to a palliative care specialist or organises your admission to hospital or a hospice if your circumstances change
- may be able to assist your family and carers with grief issues, and can refer you to counselling if necessary.
- coordinates other health professionals and works out what care you need, including home nursing or personal care assistance
- makes sure you have access to medicines and other treatments for pain and symptom relief, and talks to you about how to take your medication
- helps you with practical things, such as knowing what to expect and how to pace your day.
Palliative care specialist or physician
- prescribes or recommends treatment for pain, nausea, constipation, anxiety, depression or shortness of breath, and any other symptoms you may have
- may be able to visit you in your home, as well as in hospital, a residential care facility or hospice
- communicates with and advises the oncologist and your GP so your treatment is well coordinated
- may refer you and your family to a grief counsellor or a psychologist
- assists with decision-making about care choices.
Counsellor or psychologist
- encourages you to talk about any fears, worries or conflicting emotions you may be feeling
- helps you to work through feelings of loss or grief
- assists you and your partner with relationship issues
- helps you resolve problems so that you can find more pleasure in your life
- teaches you strategies to handle anxiety
- may show you meditation or relaxation exercises to help ease physical and emotional pain
- helps you to communicate better with your family
- provides bereavement care to your family and carers.
Pastoral carer or spiritual adviser
- supports you in talking about any spiritual matters on your mind
- reflects with you about your life and helps you search for its meaning, if appropriate
- helps you to feel hopeful and develop ways to enjoy your life despite your illness
- may organise special prayer services for you
- connects you with other members of your faith
- may discuss emotional issues, as many are trained counsellors.
If you have certain cultural or religious beliefs about death and bereavement, or certain family customs, talk to your palliative care team early on. Your customs can often be integrated into your palliative care.
- provides counselling and emotional support to you and your family, including working through feelings of loss and grief
- assists with communication within the family, including any relationship issues
- discusses ways of coping and how to emotionally support your children or grandchildren
- provides information and referrals for legal matters, home respite care, meal services, parking schemes, personal alarms, laundry services, and aged care services
- helps you access financial support you’re eligible for.
Occupational therapist or physiotherapist
- helps make the physical aspects of your daily activities easier, such as walking, bathing, and getting into and out of bed and chairs safely
- organises equipment hire or modifications to your house for a safer, more accessible environment
- teaches carers and family the best ways to move you or help you sit and stand
- assists with pain relief techniques, such as positioning your body appropriately, using hot and cold packs, and stimulating certain nerves in your body
- advises you on physical aids to improve your mobility, such as a walking frame or a device to help you put on your socks
- shows you how to exercise to reduce pain and stiffness, and to increase mobility and energy
- may also work with a massage therapist for relief of stiff and sore muscles or swelling.
- gives you access to prescription and over-the-counter medication
- provides information about how to take medication, and any side effects or interactions with other drugs
- communicates with the prescribing doctor, if necessary
- helps you with symptom management so you can achieve the best possible quality of life
- assists you or your carer with keeping track of medications, including the costs on the Pharmaceutical Benefits Scheme (PBS).
- works out the best eating plan for you and your family
- helps you choose appropriate food and nutritional supplements
- tries to resolve any digestive issues, such as poor appetite, nausea or constipation
- assesses and helps you deal with eating and swallowing problems.
If your GP refers you to a dietitian in private practice as part of your Enhanced Primary Care (EPC) plan, you are eligible for a Medicare rebate. To find out more about how dietitians can help you, visit the Dietitians Association of Australia website, www.daa.asn.au.
Volunteers can be an important part of a palliative care team. They carry out a range of support activities, such as helping directly with your care, taking you shopping or to appointments, giving your carer a break, minding children, doing basic jobs around the house, or simply providing companionship and a non-judgmental presence.
Some specialist palliative care units include volunteers who become part of the team. Usually volunteers only help out with specific, agreed tasks.
Despite being unpaid, volunteers are bound by the same professional standards as paid members of the team. They go through a thorough selection process that includes training and criminal history checks. If you think a volunteer would be of help, talk to your nurse who can refer you to the coordinator of volunteer services in your area.
You could also ask someone you know to volunteer to help you. Although you may feel embarrassed about asking for help, you will probably find that many people want to do something for you. If someone offers to help, give them a particular task so that they don’t have to guess what might be useful for you.