What is palliative care?
Palliative care is provided to people who have an illness that can’t be cured. It aims to help people achieve the best quality of life they can, including remaining as active and well for as long as possible.
Getting palliative care doesn’t necessarily mean that you’re likely to die soon. You can receive palliative care at any stage of your illness, whether it’s terminal or not. Some people receive palliative care for many years, while others receive it only during their last weeks or days.
You can also have palliative care alongside other treatments, therapies and medicines aimed at controlling your illness, such as chemotherapy or radiotherapy. This is one of the ways that it differs from end of life care, which focuses on the last 12 months of life. At that point, palliative care may become part of the package of end of life care and any unnecessary treatments are stopped. The focus of palliative care is on managing symptoms and keeping you comfortable.
Your GP or other healthcare professionals involved in your care can advise you on how to access palliative care.
How palliative care can help
Palliative care provides a range of support and services for a patient, and for their families and carers. This can include specialist medical treatment, psychological or spiritual support and practical advice. It takes a holistic approach that addresses your total needs, not just your specific medical condition.
For example, a palliative care team can:
- provide advice and help with controlling physical symptoms, such as pain, nausea and fatigue
- help you cope with the emotional, psychological and spiritual aspects of living with an incurable illness
- help you plan for the future, for example, adjusting to life changes or discussing how and where care can be provided
- provide or arrange social care, including help with things such as washing, dressing or eating
- support your family and friends – even if you do not want to have palliative care yourself, your family and friends can still access help
- arrange transfer to a hospice, hospital or care home, if needed.
Palliative care also has a role to play in affirming life and normalising the process of dying. This includes allowing death to come at its own speed, neither hastening it nor trying to postpone it.
People who receive palliative care are generally very positive about it. Research* shows that those who receive palliative care at home are more likely to die at home, in line with their wishes, and feel that their symptoms are managed better.
Who provides palliative care?
Palliative care is provided by a range of professionals. Some of those will be general health and social care professionals who provide palliative care as part of their roles, including:
- your GP
- district or community nurses
- social workers
- care workers
- chaplains or other spiritual leaders.
If you have more complex needs, you may see specialist care professionals who have been trained in providing palliative care. They include:
- palliative care doctors
- nurse specialists, such as Macmillan nurses or Marie Curie nurses
- specialist health professionals, such as physiotherapists, occupational therapists and dieticians
- specialist social workers.
In many parts of the country a number of these professionals will work together in a community palliative care team – often managed by the local NHS trust – to provide specialist support for people facing serious conditions.
Palliative care at home
Palliative care is often offered to patients in their own home. As long as adequate care can be arranged, many people prefer the reassurance of remaining in a familiar environment.
Your GP can advise you on the care services available in your area. This can include arranging home visits by a community nurse. You may also be assigned to a community palliative care team, which can provide more specialised care. Most hospices can also provide care and support at home. Your local authority’s social services team is another important source of care at home.
For more detail on the pros and cons of getting care at home, and who can help to provide it, read our article on End of life care at home.
Palliative care in a care home
If you’re unable to stay at home, you could consider a care home for palliative care. They have trained staff available to provide personal care, such as help with washing and dressing. Read more about choosing a care home.
If you or a loved one currently live in a care home, you should find out whether it can provide the care and support you require, including support from a GP and specialist nurses.
If your needs are more complex or you have very restricted mobility you may want to think about moving to a nursing home. They can provide 24-hour nursing care alongside help with personal care. If you do require this level of nursing care you may be entitled to NHS funding towards the costs. Read our articles on NHS funding for care to find out more.
Some key questions to consider if choosing a care home for palliative care include:
- Will you be close to family and friends?
- Do care home staff receive regular end of life care training?
- What arrangements are there in the home for care and support from a GP and community nurses?
- Will you still be able to see your current doctor if you move into the home?
- What does the care regulator (for example, the Care Quality Commission in England) say about the service?
- Is the care home accredited for the quality of its service? For example, the Gold Standards Framework offers training and accreditation to care providers to ensure a high standard of care to patients at the end of life.
Palliative care in hospital
Many hospitals have palliative care teams based on site. They work alongside and help hospital staff to care for people nearing the end of their lives. They can provide the same type of help with managing symptoms and the emotional, psychological and practical support that you’ll find in your community palliative care team. They also work closely with hospices and other agencies providing care in the community.
In most cases, a member of the medical or nursing team looking after you will refer you to the hospital palliative care team. You may also be able to refer yourself.
Read our tips on getting the best care in hospital.
* (Source: Gomes, Calanzani, et al., `Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers’, Cochrane, 2013.)
End of life care helps people approaching the end of their lives to live as well as possible in the time remaining.
Many people express a wish to die at home. With support from GPs, hospices and palliative care, this can be possible.
Hospices provide support to people as they reach the end of their lives. Find out about the support they can offer.