By Jude Roberts, Staff Writer
Some people may need a more complex form of care
from the beginning. This would include people: with
a past history of psychiatric problems or substance
abuse problems; who had difficulty coping during
earlier cancer treatment; with no social support, or
no one to turn to for emotional support; who have
young children in the family; who have suffered from
multiple losses; with financial problems; who have
problems thinking clearly; who have other serious,
medical problems; who have communication problems
(difference in language, or are hard-of-hearing);
who have family problems; or who have repeatedly
requested physician-assisted suicide. Whatever the
situation, the palliative care team will work with
the appropriate mental healthcare professionals,
medical professionals, social services, or
interpreters to make sure that their needs are met.
During the final days and hours, the doctor and
palliative care team will: watch the patient
closely; provide privacy; stop all diagnostic
testing; avoid needle sticks; remove IVs, catheters,
and implanted devices; allow loved ones and their
family uninterrupted time together; ensure that the
family understands the death process and what to
expect; encourage visits by children if it’s okay
with loved one; make sure the family is available
around-the-clock; make sure that caregivers
understand the advance directives of their loved one
and that these directives will be honored; and
consider sedation for relief of uncontrolled
symptoms. After a loved one has died, the palliative
care continues, making sure that the body is treated
in a culturally sensitive and respectful way, that
the family has time with the body, that funeral
arrangements are made and finalized, and that all
healthcare professionals and insurance companies are
notified. For the family, the palliative care team
will help provide support with their grief by
identifying available help or community
grief/bereavement groups, and will make sure that
family members are receiving the help needed in
order to cope with the death.
It’s important for caregivers and their loved
ones to know that such a program exists, that it can
help them through every difficult stage; not only
helping the one with the life-threatening illness,
but also helping the caregiver. Palliative care can
ease the confusion that may come from an overload of
too much information and too many choices by
concentrating on the entire person - their body,
mind, and spirit - and the personal well-being of
the family caregiving team as well.
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