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Roles in Palliative Care

 

 

Members of the Palliative Care Team and their RolesRobin Fainsinger

 

Family Doctor

The family doctor is in charge of a person's medical care and works closely with the patient, the patient's family, and the palliative home care. The family doctor needs to have a doctor on call 24 hours a day, make home visits when a person is too sick to leave home, and work with the home care.

The family doctor can ask for a palliative care consult to see the person, admission to a hospice unit, tertiary palliative care unit or an appointment at an outpatient clinic. Home care can assist in finding a family doctor if need be.

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Consultants

Palliative consultants are doctors and nurses with special training in palliative care. The consultants assist family doctors in order to plan care for the patient, can visit a patient in his or her home, hospital, hospices. They are on call 24 hours a day, 7 days a week.

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Dieticians

The dietician's role in palliative care includes doing a nutrition assessment, teaching about diet, helping the person and family to make choices about food and diet supplements. A dietician also helps with such symptoms as problems swallowing, poor appetite, nausea, vomiting and constipation

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Nurses

Nurses

Nurses work in a variety of roles within the Edmonton Zone Palliative Care Program. Registered nurses (RNs) include front-line nurses in hospice, home care, and the Tertiary Palliative Care Unit, nurse managers, nurse consultants, nurse practitioners, clinical nurse specialists, and clinical nurse educators.  Nurses in the program have additional education, training, and expertise in palliative care. RNs plan, direct, and coordinate care. Licensed practical nurses (LPNs) collaborate with RNs and other health professionals to provide direct care.

Definitions:
Nurse Managers: RNs who provide leadership to their teams, units, and throughout the program.
Nurse Consultants: Registered nurse consultants have additional training and expertise in palliative care. RN Nurse Consultants work with Physician Consultants to make recommendations to the patient’s primary care physician regarding pain and symptom management, and assess patients for admission to hospice or the TPCU. They consult with patients and families in their homes or hospital settings.
Nurse Practitioners: RNs who practice at an advanced level. Their role is primarily clinical, and they are able to order and interpret diagnostic tests, communicate diagnoses, prescribe pharmaceuticals and perform specific procedures.
Clinical Nurse Specialists: RNs who practice at an advanced level. Their role depends upon the setting, and includes leadership, clinical consultation, education, and research.
Clinical Nurse Educators: RNs whose role is focused on education. They develop, coordinate and provide educational activities.

Unregulated Health Care Provider

Unregulated Health Care Providers include nurses’ aides, personal support workers, health care aids, and home support workers. Unregulated health care providers work under the direction of nurses and in collaboration with the Palliative Care Team to meet the care needs of palliative care patients, including providing personal care and feeding.

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Occupational Therapist

The OT (occupational therapist) assesses each person's needs and offers practical suggestions for daily activities, works with the person and their families to help them do things that are meaningful to them and can help with relaxation exercises. The OT also finds, adapts or makes equipment to help the person with independence and teaches the person how to save his/her energy.

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Physiotherapist

The physiotherapist helps with patient positioning including reducing pressure on sensitive areas, pain relief, including TENS, heat and cold massage, and mobility including in bed, on foot or by wheelchair. THe physiotherapist also provides chest physio, excercises and education to family and staff on how to move someone gently and position them in bed or a chair.

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Recreational Therapist

The recreational therapist helps to plan activities of interest to the person and helps with comfort and relaxation.

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Rehabilitation Therapist Assistant

The rehabilitation therapist assistant aids the physiotherapist and occupational therapist to give care to the patient and helps with comfort and relaxation.

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Social Worker

The social worker helps the person and the family deal with the personal and social problems of illness, disability and impending death. The social worker helps by setting up family meetings to discuss hopes and goals, makes referralys to community services (ex: financial help), aids in planning discharges to home, hospice or hospital care, provides support to the person and their family. Before or after death the social worker also helps the family think of ways to take care of themselves and coping with loss and grief.

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Chaplain

A chaplain's role in palliative care is to help the person express and reflect upon his/her spirituality in the face of illness. They help in identifying and expressing spiritual issues, help with the search for meaning the the person's life, and celebrate life in the midst of pain and suffering. The chaplain helps the person reflect on faith and matters of faith such as prayer and ritual, networks with community faith groups may provide support in the planning of memorial or funeral services

The chaplain must respect ALL faiths, is caring, sensitive and supportive to people during illness, grief and bereavement and is a good listener who affirms a person's worth.

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Pharmacist

The pharmacist can give advice on the side effects of the medication, teach the person and the family how to take the medication and what to do if there are side effects, give the doctor advice on how to give the medication, help set up a schedule for taking medications, prepare the medication, and provide ongoing monitoring of all medications.

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Respiratory Therapist

A respiratory therapist can look after and follow a person who is having breathing problems, advise and teach on the use of oxygen, suctioning and medications to help with breathing and help to get oxygen at home for the person.

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