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Feature Article

Palliative care: physical and spiritual wellbeing at the end of life

Alison White

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Abstract

Palliative care can improve quality of life and potentially prolong survival through early management of physical symptoms and psychospiritual distress. It should be considered for any patient with a life-limiting illness, well before they require terminal care, and can be offered alongside active treatment. Every healthcare provider should have the skills to offer general palliative care, with referral to specialist palliative care services in more challenging situations.

Key Points

  • The prevalence of cancer and chronic noninfective disease is increasing, and approximately half of all deaths in Australia are reasonably predictable because of a diagnosis of a life-limiting illness.
  • Palliative care promotes quality of life through early identification, assessment and management of physical symptoms and psychological and spiritual distress.
  • Fewer patients with noncancer diagnoses are referred to palliative care, but patients with life-limiting noncancer conditions also have a high prevalence of symptoms including pain, dyspnoea, fatigue, anorexia and anxiety.
  • Unmet spiritual needs can contribute to increased physical and psychological distress.
  • Early integration of palliative care with other patient care, including active care, is associated with survival benefit.
  • Palliative care is appropriate early in the course of life- limiting illness and in conjunction with life-prolonging therapies.

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