Who provides palliative care?
There are two groups of people who provide palliative care: non-specialists and specialists.
Who are the non-specialists?
These are the people who are involved in day-to-day care of patients, both at home and in hospital.
For example, in the UK, there will be a multidisciplinary team (MDT) in the community. An MDT is a team of people who have different jobs (disciplines). The MDT will usually be made up of:
- District (community) nurse(s).
- General practitioner(s).
- Practice nurse(s).
- Macmillan nurse - a specialist palliative care nurse, usually attached to a hospice or hospital department.
- Social worker.
- Practice manager, for administrative support.
The team may be much bigger depending on individual circumstances. For example, it may well include informal carers, such as family, friends, neighbours or volunteers.
The professional members of this team will meet at least every three months to discuss everyone in their practice with palliative care needs, to ensure that they are being met. This involves making sure that there is someone who the patient knows by name. This person will keep them involved and make sure that they have the opportunity to talk about how they would like their needs to be met. This will include end-of-life care if appropriate.
This team should be able to provide palliative care under normal circumstances but may need to ask for help or advice from specialist palliative care services.
Who are the specialists?
These are the people whose work is likely to concentrate particularly on people who need palliative care. They may provide this care in hospital, in a hospice, at your home or at a day centre, as well as being available to give telephone advice. For example:
- Specialist palliative care physician.
- Specialist palliative care nurse - for example a Macmillan or Marie Curie nurse in the UK.
- Social worker.
- Art and music therapists.
- Bereavement therapist.
- Dietician - can provide personal advice if you have lost weight and can't face food.
- Occupational therapist - to help you overcome practical difficulties in everyday life.
- Speech therapist - provides advice not just on speech problems but swallowing too.
- Complementary therapist - providing, for example, massage or aromatherapy.
- Religious and spiritual carers - their kindness, compassion and deep listening are appreciated by patients and their families of all and no religion.
- People from voluntary organisations, such as Citizens Advice.
- Hospice volunteers - may provide anything from hairdressing to gardening to bereavement counselling.
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