Palliation in chronic illness

![CDATA[Palliative care is a philosophy of care for people across all age groups who have been diagnosed with a serious, progressive and life-shortening illness. With the growth and ageing of Australia's population, and an increase of chronic and generally incurable illnesses, the types of patient groups requiring palliative care h as widened (Australian Institute of Health & Welfare (AIHW) 2013 ). Examples of these conditions include chronic obstructive pulmonary disease (COPD), dementia, Parkinson's disease, multiple sclerosis, end-stage kidney disease, cancer and cardiac disease. Palliative care is provided by a multidisciplinary team approach; however, it is the nurse who will predominately be presen t during the end-of-life stages. Palliative care nursing is guided by the promotion of quality of life across the illness trajectory by relieving suffering while providing care for the dying (Ferrell, Coyle & Paice 2015 ). Broadening the scope of practice in palliative care is therefore necessary to enable care for all patients with life-limiting illnesses. Standards of care for palliative care have been developed by the peak body, Palliative Care Australia (PCA), with the underlying philosophy 'reflecting the need at the time to clearly articulate and promote a vision for compassionate and appropriate end-of-life care' (Palliative Care Australia (PCA) 2016, p. 3). This chapter will provide a brief overview of the historical development of palliative care. Discussion will then focus on contemporary issues and challenges to providing care for patie nts with cancer and other life-Limiting illnesses. The management of chronic illness is often complex and poly-symptomatic; individual planning is therefore a crucial component for successful nursing intervention . Two clinical case studies will be used to display examples of how philosophy and practice principles come together to guide care. These principles ensure that a holistic patient-centred palliative approach is underpinned by core skills throughout the chronic illness trajectory. To be successful, this approach requires a collaborative approach by a multi-professional team, which also includes doctors, allied health care disciplines, community support groups and, increasingly, complementary and alternative health practitioners. Each team member will be guided by the same underlying principles of care, but will have a unique role to fulfil in an effort to meet the needs of the patient. The multi-professional team approach will be utilised in the case studies to show how key players can be incorporated into an effective plan of care.]]