5. Definition of palliative care
Palliative care is an approach that improves the quality
of life of patients (adults and children) and their
families who are facing problems associated with life-
The service is mainly provided to advanced cancer
patients and their families.
7. Goals of palliative care service:
- Improve the quality of life of patients with
- Control of distressing symptoms, such as
pain, shortness of breath, nausea,
vomiting and constipation.
9. Our palliative care team provides its services in a
Our team includes:
- Palliative care physicians and nurses
- Social worker
- Health educator
- Spiritual care provider (Sheikh)
- The primary caregiver of the patient
Whenever indicated; the medical care plan is arranged
with other medical and / or surgical subspecialties.
11. Palliative care service is provided to our
patients according to the latest Regional
and International palliative care medicine
guidelines, with emphasis on:
- Respecting patient’s privacy and dignity.
- Providing sympathy with patients and his
- Respecting patient’s autonomy.
13. The medical care is planned with the patient
and his primary care givers.
Whenever feasible, the medical care is
provided at home.
Patients are then followed regularly at home
by the home care team.
Patients are given scheduled outpatient
Patients and their primary care givers are
educated and oriented regarding the
alarming symptoms requiring
22. 2- Who will assess the palliative
Palliative care team
Spiritual care provider (Sheikh)
23. 3- Where to assess ?
• Clinic visit.
• Inpatient bed.
• Home care visits.
24. 4- How to assess the palliative
care patient ?
1- History (Personal, Operative, Medications, chronic
2- General examination (vital signs, weight, height,
3- Local systemic examination (by physician)
4- Palliative assessment :
a - Performance status
b - Symptom assessment
c - Specific precautions
d - Special assessment (nutritional, psychological,..)
e - Phases of palliative care delivery
30. C- Specific precautions :
1. Arm precautions (in breast cancer)
2. Fall precautions (elderly, delirium)
3. Isolation precautions (Neutropenic patients)
4. Stoma care (gastrostomy, tracheotomy,
5. Wound care and repositioning (bed-bound
31. D- Special considerations :
1- Psychological assessment
(Depression, anxiety, …)
1- Nutritional assessment :
• Manageable causes (Anorexia, nausea or vomiting)
• Potentially curable causes (Dysphagia, ulceration)
• Caloric requirements
• Route of delivery (oral, NGT, gastrostomy, TPN)
• Follow up the progress
32. E- Phases of palliative care delivery:
1- Stable phase
Clear management plan
Regular clinic visits, no or minimal hospital
Mainly patient-directed care
PPS between 100% and 70%
33. 2- Progressive phase
Distressing increasing symptoms
Maximum patient suffering
Patient and caregiver-centered care
Recession of curative treatment
Full supportive care
Frequent hospital admissions
PPS between 60% and 40%
34. 3- End of life phase
Patient’s wish for place of care
Ensure symptom control
Only effective simple medications are used
Routes of administration are reviewed
Family meetings to prepare for the expected
Social worker support (wills, financial issues,
custody arrangements for children,…)