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Palliative cancer care - general issues - Management
Goals
- The psychological needs of all patients and carers are assessed on a regular basis throughout the patient pathway, with attention given to those points known to be particularly challenging (e.g. around the time of diagnosis, at recurrence of disease, as treatment ends, and in bereavement)
- Patients and carers are offered psychological support appropriate to their needs, with those experiencing particular distress referred to professionals with specialist expertise
- The psychological needs of staff caring for patients and carers facing difficult circumstances are adequately met
- Social care needs of individual patients and carers are identified and addressed
- Patients and carers experience a coherent and integrated system of social support, matched to their personal circumstances, to ease the social consequences of living with cancer
- Practical and financial support is available to patients and carers, where and when needed, and in a way that is acceptable to them
- Patients and carers receive support, if sought, to make sense of difficult life events through an exploration of spiritual and existential issues, including an effort to foster hope and promote well-being within an integrated care approach
- Health and social care professionals are able to acknowledge spiritual issues among patients and carers and to respond in a flexible, non-judgemental and non-imposing way
- Spiritual needs of staff are recognized, with support available to them in this area of care
[NICE, 2004]
- To recognize the need to assess the person's physical, psychosocial, and spiritual needs promptly and at regular intervals
- To relieve the person's symptoms and fears
- To enable the person to die in the place of their choosing whenever possible
- To involve the person, carers and family members in discussions about management changes and to keep them as informed as possible
[Ellershaw, 2006]
- To document the wishes and preferences of the person and carers in an Advance Care Plan (in line with the Mental Capacity Act 2005)
- To arrange effective out of hours handover and anticipatory prescribing
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