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Catholic Diocese of Maitland-Newcastle www.mn.catholic.org.au
CARING FOR THE LIVING
AND THE DYING
Member s of the Palliative Care Team at
Calvary Mater, Newcastle, answer some
frequently asked questions about this aspect
of medicine. Contributor s are Staff Specialist,
John Cavenagh, Acting Nurse Unit Manager,
Jessica Cain and Pastoral Care Manager,
Mary Ringstad. Palliative Care Week will be
obser ved 25-31 May.
Q What does the word 'palliative' mean?
A The word 'palliative' is often used to
describe a type of health care. Palliative
care refer s to the active total care of
patients whose disease is not responsive
to curative treatment, and so is life -limiting.
It is an approach that improves the quality
of life of patients and their families facing
problems associated with their illness
through the pr evention of suffering by
means of early identification and thorough
assessment of pain and other problems -
physical, psychological, spiritual, emotional
"The goal of palliative care is the
achievement of the best possible quality of
life for patients and their families." (World
Q What does the word 'hospice' mean?
A Historically, the word 'hospice' meant
a place of lodging, rest and refreshment
for a tr aveller. Over time the word has
become synonymous with a place that is
dedicated to providing specialist care and
symptom management to those living with
a life-limiting illness. This holistic approach
to care is provided not only throughout
per son's time of illness, but also in the
bereavement following death.
Q Must a person be dying to receive
palliative care or is it also for people who
are very ill but not necessarily dying?
A The Depar tment of Palliative Care
based at Calvary Mater, Newca stle (CMN),
cares for patients and families living with
active, progressive advanced disease. It is
delivered wherever the patient is. Most
patients admitted to the ser vice are in
their own homes, being cared for by their
carers/families. Patients remain at home as
long as their circumstances allow and many
patients ar e exper tly cared for by their
carers/families in their homes until they
die. When care at home is not possible
for any reason (eg uncontrollable physical
or psychological symptoms, severe pain, a
need for respite care, or end-of-life care),
a specialist inpatient facility, the Mercy
Hospice, on the CMN campus, is available.
This unit is staffed by experienced palliative
care staff including nurses, medical staff and
allied health professionals. Some patients
will be discharged home or to family with
suppor tive community ser vices in place.
Some with stable care needs may be
transfer red to a residential aged care facility.
Others will die during their admission.
Q What resources/contacts can palliative
care provide for patients?
A Palliative Care, based at CMN, is
delivered by a multidisciplinary team
consisting of nur sing, allied health and
medical specialists in palliative care. We
provide both a specialist inpatient facility
(the hospice) and outpatient ser vices
within a limited geogr aphic area . In
addition we have access to a large number
of specialist disciplines eg medical oncology,
radiation oncology, haematology, general
medicine and psychiatry, which can provide
advice and guidance to the palliative care
team as required. The allied health team
provides a program each Monday for both
patients and carer s /families . This program
focuses on the provision of emotional
suppor t and infor mation. In recognition
that referr al to palliative care may signify
an important but
difficult time of
relevant to assist
patients and carer s
newly referred to
Ser vice visits patients
at home. The nur sing
and medical ser vices are
available 24 hour s , 7 days a
week, with allied health professionals
available during business hours; Monday-
Friday, 8am -4pm. This ser vice cover s
an approximate 20km r adius from the
Q What resources/contacts can palliative
care provide for families?
A The palliative care multidisciplinar y
team has recently been involved in a
national collaborative quality improvement
project specifically focusing on the needs
of families/carers. The ser vice is very
aware of the impor tant roles of carer s
and how their effor ts need professional
suppor t. Respite admissions for patients
may be required because the carer needs a
break from the heavy responsibilities they
generously provide. Families have access
to emotional suppor t, counselling, spiritual
care, assistance with equipment and
accessing services as needed.
Q Are there specific resources available
to young children and teenagers with a
parent who is seriously ill?
A All staff are attentive to the needs of
children and teenagers with a seriously ill
parent. A social worker and pastor al care
pr actitioner ar e available to attend to the
psycho-spiritual and psycho-social needs of
children. Our social worker also liaises with
the medical and nur sing staff to ensure
children have the oppor tunity to discuss
issues of concer n and questions about the
medical condition and care of their parent.
Contact is made with school counsellors
when requested and with other agencies
in the community like Canteen, Make
Today Count and gener al pr actitioner s .
Appropriate bereavement follow-up is also
Q Do volunteers work with palliative care
A Volunteers are an impor tant par t of
the Palliative Care Team and work in
the inpatient unit, Figtree Progr am and
Bereavement Suppor t Ser vices. Volunteers
are required to complete the hospital-
based education progr am and can be easily
recognised by their 'Volunteer' badge with
their fir st name.
Q What measures do staff take to
ensure the comfort of patients?
A Palliative care, medical
and nur sing staff focus
on pain and other
symptoms that may be
causing distress. Most
symptoms can be
managed. In addition,
families are suppor ted
by the provision of
on the patient's condition
and every effor t is made to
ensur e a patient dies peacefully.
Along with phar macological inter ventions ,
good symptom r elief is achieved using
non-pharmacological strategies such as
emotional suppor t, diversional therapy,
counselling, massage therapy, spiritual care,
functional assessment and the provision of
aids and equipment.
Q Are patients able to have pets visit
them in the palliative care ward or
A We recognise there are many benefits
in allowing patients to bring pets to the
hospice with them or have them visit
during their time of admission. Having
pets visit can reduce anxiety and stimulate
memory, communication and inter action.
Pets are welcome as long as the
established guidelines for visiting/staying
Q Does the palliative care ward/hospice
have pets that visit patients?
A During our weekly Figtree Program
par ticipants enjoy the company of Daisy,
the Maltese Shitzu, who visits each week
with its owner, a valued volunteer. The
Figtree Progr am is a group suppor t
progr am for inpatients and outpatients
offering oppor tunities for social contact
and suppor t, and engagement in a wide
r ange of activities including creative ar ts,
life review, meditation and exercise.
Q Are families able to visit at any time?
A The Mercy Hospice allows visitor s
between 8am and 8pm each day and
arrangements outside these hours are
made through the Nur se Unit Manager.
When a per son is close to death we are
ver y attentive to the specific needs of the
Q If patients prefer to stay in their home,
what ser vices can be provided?
A When a per son prefers to stay at home
to die, our Outreach Team works with
the patient's GP, community nur ses and
other ser vice provider s to ensure that
the patient is comfor table, symptoms are
well managed, the family and patient are
prepared for death and a plan is in place.
Q Once a patient dies, is there support
for the family afterwards?
A We have a comprehensive bereavement
progr am available to all families and
carer s of deceased patients who were
registered with the Palliative Care Ser vice,
ir respective of where they may die. We
offer someone to talk to about your
experience; counselling; Remembr ance
Ser vices ; telephone suppor t; infor mation
about what to expect when grieving;
acknowledgement of the anniver sary;
suppor t groups; referr al to another
appropriate organisation/ser vice.
Q How long can a family sit with a patient
who has died?
A As long as the family or any individual
within the family, feels they need. It can be
hours. Often some family member s may
not be with the per son when they die and
they wish to come in to see their family
member after he or she has died. We are
ver y sensitive to the needs of family at
this time and the ongoing significance this
moment may be in someone's grieving.
Hence we try to meet the needs of all
involved with sensitivity and flexibility.
Q How is this ser vice different if the
patient is a baby or child?
A The principles of palliative care are
the same, irrespective of the patient's
age. There is now a number of specialist
paediatric physicians in palliative care in
NSW and one works at the John Hunter
Hospital (JHH) Children's Hospital as par t
of a paediatric palliative care team that
also includes a social worker, occupational
therapist and a clinical nur se consultant.
Recently the JHH Children's Hospital
refurbished two inpatient rooms to better
meet the needs of children who are dying
and their families.
If you would like to discuss accessing
palliative care in your area, your GP is
best able to advise you. If you would like
to learn more about palliative care, The
Cancer Council has booklets or visit
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