A Palliative Care Overview

Palliative care is an approach to care that supports the clinical, emotional and spiritual needs of individuals and their families coping with a life-limiting illness. Palliative care and a palliative approach to care focuses on comfort and support to the person and family, assists with making plans and decisions for the journey ahead, and optimizes quality of life. Sharing health care wishes and goals with loved ones, doctors and other health care providers is important.

A palliative approach to care is best started early when a person is living with a life-limiting, cancer or non-cancer, illness or injury. It offers opportunities for recurring and meaningful quality of life conversations while a person is receiving ongoing health care and treatment, including treatment aimed at a cure. A palliative approach to care supports a person’s overall well-being and addresses the nature of the life-limiting illness and associated psychological, physical, emotional and spiritual needs over time. A palliative approach to care can be provided months and years in advance of end of life care.

• Engage in advance care planning, serious illness and goals of care conversations
• Optimize quality of life and align with desired treatments and interventions
• Provide early symptom assessment and management, concurrent with medical treatment
• Provide person and family education on nature of health condition
• Share information related to potential health authority and community-based services

Palliative care is ideally provided during the last 6 months to one year of life and continues to be guided by the person’s known wishes and priorities. Treatment remains active and may or may not continue to be aimed at a cure, addresses ongoing symptom management, focuses on quality of life, and living as comfortably as possible to the end of life. It is important that referrals to additional services are made in a timely manner and that all palliative care options are discussed and the individual’s choices are respected. This may include questions and planning related to medical assistance in dying (MAiD).

• Engage in ongoing serious illness and goals of care conversations, including MOST and possible treatment choices
• Provide regular symptom management to relieve symptom burden
• Provide holistic, person-centered support to enhance quality of life
• Provide upstream and timely referrals to health authority and local hospice society services
• Palliative respite can be offered to individuals for symptom management or to provide relief for caregivers
• Offer family education on supporting a loved one with an advancing illness and preparing for end of life care

End of life care is provided during the final days and weeks in which the person is still alive and when time is very short. The goals of care are to ensure comfort through active symptom management, emotional and spiritual care, and to continue to honour the expressed wishes of the person. This care includes understanding what is meaningful and dignified for the person during the dying process, and knowing where the person prefers to die and their after-death care wishes.

• Guide important end of life care conversations to support the person and loved ones during these final days and weeks
• Provide comfort care for symptom management
• Provide coordinated care for the family and loved ones to support the dying wishes of the person
• Offer bereavement and grief supports and make timely referrals for services