Palliative care is described by the World Health Organisation as a holistic approach which promotes quality of life for patients and their families in facing the problems associated with life-threatening illness. This is achieved through the prevention and relief of suffering, and by addressing physical, spiritual, social and psychological issues.
Whilst palliative care has historically been associated with malignant disease, its extension beyond cancer care has long been advocated. This was noted in the report of the National Advisory Committee on Palliative Care (NACPC) in 2001. The continuing limited access to specialist palliative care services (SPCS) for patients with non-malignant disease, notably COPD, Dementia and Heart Failure, led to the publication of Palliative Care for All – also known as the “Extending Access Study” – in 2008. One of the key messages of that report was that palliative care needs to be incorporated into disease management frameworks, and for SPCSs to accept referrals based upon need rather than diagnosis.
The report of the NACPC, which has been adopted as government policy, remains the blueprint for palliative care services in Ireland. It defines three levels of palliative care, Level 1 providing palliative care in the home, Level 2 providing general, non-specialist palliative care and Level 3 providing specialist palliative care.
In Donegal, ‘Closer to Home’, a nurse-led initiative within the community nursing palliative care service, has achieved the development of Level Two palliative care support beds in Community Hospitals. The implementation, on a phased basis, provides a patient-centred approach and a standardisation of care and enhances communication amongst health care professionals. The critical outcome of this initiative is the delivery of the highest levels of clinical care for our terminally ill patients closer to their own home.Tags: