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Canterbury DHB

Hospital Palliative Care Service

The word "palliative" is derived from the Latin pallium, a cloak or cover, and implies a form of care that:

• recognises that cure or long term control of disease is not possible
• is concerned with quality rather than quantity of life
• 'cloaks' or relieves troublesome and distressing symptoms

The aim therefore of Palliative Care is to maximise the quality of the person's life. This is achieved by delivering and co-ordinating a range of services in response to the individual needs of the patient/family/whanau.

The goal of Palliative Care is work alongside patients to facilitate the achieving and maintaining of maximum physical, emotional, intellectual, spiritual, vocational, cultural and social potentials, however limited they may be as a result of disease progression.

Palliative Care recognises dying as a normal process and aims to neither hasten nor postpone death.

The Palliative Care approach should be an integral part of all clinical practice.

Palliative Care is part of Oncology Services and our office is located within the Oncology Department, Ground Floor, Parkside West, Christchurch Hospital.

Outpatient Clinics are in the Oncology Outpatient Department on the ground floor.

The "Team"

We provide the following services

• Specialist palliative care advice and support to patients and their families/whanau and to other clinical staff
• Liaison with other services both within the hospital and the community, including
  • Hospital multidisciplinary teams
  • General Practitioners
  • Nurse Maude Centenary Hospice
  • Community Palliative Care Nurses
  • District Nurses
  • Rest Homes and Private Hospitals
  • Counselling and Bereavement Services
• Palliative Care Clinics for new patients and follow-ups, referred by hospital specialists or by general practitioners
• Formal and informal education, including
  • in-service education
  • multidisciplinary study days
  • orientation and new graduate teaching
  • ward teaching
  • undergraduate and post graduate medical education sessions
  • Rest Home and Private Hospital education sessions
• Staff support - we are available to support ward staff in dealing with difficult clinical situations and with distress following a traumatic disease process or death of a patient
• Telephone advice to all health professionals

Referral is appropriate when

As a consequence of advanced/progressive disease, the patient has symptomatic or other needs (such as those outlined below) that require Specialist Palliative Care input.

• The patient has a range of symptoms relating to their illness including pain, nausea, vomiting, dyspnoea, constipation, anxiety, agitation etc that are proving difficult to manage.
• The patient/family/whanau have psychological, social, spiritual or religious concerns related to the illness.
• The patient/family/whanau need support and assistance following a diagnosis of recurrent disease, relapse or change in disease status.
• Staff member(s) require support in order to care effectively for a patient and their family/whanau.

Patients may still be receiving active treatment for their underlying disease process but the Palliative Care team can work alongside this to ensure that both symptomatic management and support is maximised.

How the Palliative Care Team works

• We provide a consultative service to all wards and areas across the CDHB.
• The "Team" consists of Consultant Physician, Specialist Palliative Care Nurses and Registrar.
• We will assess the patient promptly and where possible inpatients will be seen on the day of referral.
• We assist with planning for discharge and liaison with community services.
• We conduct Palliative Care clinics for both new referrals and follow-ups.

Making a referral

• A formal referral from the primary medical/surgical team is needed using a yellow consultation request form (QMR003C) which must be faxed to 86233.
• It is important that you discuss the referral with us as well as sending the fax as this assists us with prioritising.
• We can be contacted during working hours on either extension 81473 or 81885 or via pagers 8985, 8826, or 8970 (Monday to Friday, 0830-1700).
• The patient must have knowledge of their disease and of the fact that a referral has been made to the Palliative Care Service (please discuss where concerned).
• If we have previously been referred a patient (within one year) we will see the patient again without requiring a formal referral.
• Specific issues relating to Medical/Surgical and Oncology/Haematology patients are noted below. If you are working in one of these areas, attention to these specific issues will help us liaise effectively.
• We are happy to discuss any referrals you are unsure about and to give telephone advice if required - Enquiries are always welcome.
• For problems after hours, please contact the Oncologist on call.

Topic Code: 4428