What are the five stages of palliative care?
Palliative care is commonly split into five stages, understanding these stages can help you make decisions for your own care, and ensure you and your family is getting the right support, at the right time.
Stage 1:Creating a plan
This is when your initial care plan is created. Your GP, along with any specialist medical professionals involved in your care, such as occupational or physiotherapists will work with you to set out which palliative care services you need now, and how these services can evolve as your illness progresses.
This initial plan will usually look at things like:
- Your current and future treatment plan
- The expected progression of your illness
- Essential medicines and symptom relief
- Your initial care preferences, such as whether you’d like to remain home, or if you’d like a specific form of therapy
At this stage, you may wish to start the conversation around your wishes – such as anadvanced decision, aLasting Power of Attorney(assigning a loved one to make health and care decisions on your behalf) or a living will, but don’t feel like you have to if you’re not ready.
Your advanced decision will set out when and under what circ*mstances you would refuse treatment or resuscitation, should a time come when you’re unable to make or communicate this. It’s a big decision and an important part of your care plan, so you may find it helpful to discuss the consequences of your decision with a doctor.
Stage 2:Preparing emotionally
Depending on the level of care agreed upon during stage one, your social worker, counsellor, and religious or spiritual professional (if requested) will work together to provide you and your family with emotional support and help you prepare for what’s ahead. This could include arranging a safe space to discuss your emotions with a qualified therapist, connecting with chaplaincy services to help you explore ideas around meaning and purpose, or trying complementary therapies such as massage or music therapy.
Stage 3: Early-stage care
Your healthcare professionals will look at all aspects of care that can help you to stay as independent and possible. If you’re receiving care in your own home this may include sourcing assistance for daily living from visiting carers, or setting you up with specialist equipment.
Community care nurses may be able to arrange for you to get an adjustable bed or relieving mattress on loan. If you experience shortness of breath, you’ll likely be provided with oxygen cylinders or nebulisers.
If your home requires some adaptations to help you move around safely, ask your social worker aboutGovernment funding. Most local councils will cover the cost of modifications under £1000 regardless of your income. This can help with installing things like grab rails, ramps, and temperature-controlled mixer taps.
If your needs are more advanced, you may be able to apply for a Disabled Facilities Grant of up to £30,000, which can help with larger modifications such as walk-in showers or baths and stairlifts.
Stage 4: Late-stage care
This is when your healthcare team will help you to plan more permanent, late-stage care. Often this is the stage where discussions around hospice care take place. If you choose to stay at home, they, along with your social worker will help you to arrange live-in care with a care provider with an acute understanding of your condition or illness.
It’s at stage four that end of life care begins.
