Supporting clients receiving palliative care is a strategic focus at VHA. While each palliative care client is unique, the goals of VHA palliative care are universal. We strive to support clients so they can:
VHA’s health care team can provide some or all of the following services depending on the stage of the disease and your geographic region.
Palliative care nursing focuses on improving a person’s ability to tolerate medical treatment and having control over their care by understanding treatment options. Our palliative care nurses are specially trained to deal with complex pain, symptom and medication management related to end of life conditions. Nurses also support clients living with depression, anxiety, fatigue, shortness of breath, skin integrity, constipation, bladder function, nausea, loss of appetite and difficulty sleeping. Nurses are integral to the palliative care; they provide ongoing consistent and compassionate care and often are the “co-ordinator” of the interdisciplinary team.
Personal support workers (PSWs) provide various types of care for palliative clients that hugely impact their quality of life. Activities range from providing personal care, assisting with household tasks, and providing companionship when the family is unavailable. PSWs often spend significant time with clients resulting in a bond, or trusting relationship that can help them understand the specific needs or nuances of palliative care patients.
Clients can receive palliative care physiotherapy at any stage of their illness and intervention. For clients in the early stages of palliative care the focus is on minimizing symptoms, optimizing mobility and independence, maintaining or regaining physical function and preserving the client’s autonomy. For clients at the end stage of disease physiotherapy intervention focuses on positioning in bed and respiratory care. A client and family-centred approach is used at all stages of care.
Improving quality of life and daily functioning of clients receiving palliative care are integral to the philosophy and practice of Occupational Therapy. Regardless of disease stage, Occupational Therapists (OTs) promote participation in meaningful life activities as defined by the client. This may include activities of daily living (ADL), instrumental ADLs, rest and sleep and social participation. A client-centred approach fosters a sense of independence while managing the challenges of living with debilitating symptoms.
Dietitians in palliative care have an influential role with clients throughout the stages of the disease process. Decreased appetite and food intake, weight loss, and loss of thirst and dehydration are natural processes as the body prepares to die. People usually associate food with nourishment and love, and family members may become distressed or feel guilty if they believe their loved one isn’t nourished. Dietitians can provide education related to risks and benefits of oral intake/diet as well as guide and support clients and families as the disease progresses.
Palliative social workers offer a wide variety of support to clients, caregivers and family when a cure is no longer possible and clients face a host of psychological, emotional, physical and spiritual stressors. As part of the interdisciplinary team, Social Workers (SWs) take on an advocacy role, help with problem solving and facilitate solution-finding or decision-making on behalf of the client and family.
Speech Language Pathologists (SLP) consult with clients receiving palliative care—as well as their families and caregivers—about communication, cognition and swallowing functions. The pattern of decline in individuals varies depending on the condition or diagnosis. Common deficits seen with deterioration of health status include memory impairment, motor speech disorders, reduced judgment or problem-solving skills, disorders of comprehension and impairment of word retrieval skills and sufficient breath support for speech. Complex clinical and ethical issues may leave the family and care team facing challenging decisions. The SLP may help with facilitation and communication about these issues.