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Looking after yourself when you look after people at the end of their life

Photo: Looking after yourself when you look after people at the end of their life
Nurses and allied health professionals play an important role in supporting the significant number of Australians living with chronic disease. Some of these people require care that is not curative but supportive; care that focuses on quality of life. In this case, palliative care can improve quality of life, minimise pain and help the person, the carer and family live the best life possible until death. For chronic illnesses recognised as life-limiting, this is particularly important as the person’s health or capacity for normal functioning may deteriorate rapidly and severely impact their quality of life.

The World Health Organization defines palliative care as support for physical, emotional, social and spiritual needs. This definition highlights the importance of a team approach and support for a person’s family and carers. The Australian Government 2018 National Palliative Care Strategy   has adopted this as the national definition and highlights the importance of person-centred and evidence-based care.
While cancer is commonly recognised as a life-limiting illness, others include dementia, cardiovascular disease, chronic respiratory diseases, neurodegenerative diseases (e.g. MND, MS, Parkinson’s, Muscular Dystrophy, Huntington’s Disease), diabetes, chronic liver disease, and end-stage kidney disease. It is also recognised that older people approaching their natural end of life with or without chronic illness(es) may have palliative care needs.

Life-limiting illnesses  can affect people of any age and the time course or trajectory varies depending on the condition(s) and individual factors. Palliative care may be required throughout the course of an illness or just at the end of life and involvement of allied health professionals will vary according to individual needs.

Working in palliative care can be rewarding. Good palliative care often sees the creation of strong bonds between the people who provide care and clients, their carers and families. Grief over the death of people in your care is not unusual and may contribute to stress or burnout. This should be acknowledged.

Instead of ‘protecting yourself’ by keeping a distance from clients, you can learn ways to cope with grief and develop self-care. Self-care resources for nurses and allied health professionals can help you to grieve yet still care well.

Talking to your supervisor and colleagues about what you are experiencing can help. If you need more support, request their help to find this. Talking to a GP, counsellor, or pastoral care worker may help you to acknowledge your grief and to grieve in a healthy way so that you can continue the important work that you do in supporting people at the end of their life.

Contributor:
Susan Gravier, Research Associate, CareSearch, Flinders University
Susan trained as a physiotherapist in Adelaide and has worked in regional Victoria, Canada and Hong Kong. Having worked on healthy ageing and active ageing projects for many years, she is now a researcher in palliative care at CareSearch. CareSearch and palliAGED are Commonwealth Government-funded online resources that pull together and consolidate evidence-based information and resources into accessible language and formats. CareSearch provides evidence-based palliative care information across the lifespan and across the health system, palliAGED provides that information for the aged care sector.  In 2016-2017, Susan coordinated the production of palliAGED, writing many of the topic pages in the Evidence and Practice Centres. Susan is currently leading the allied health component of the CareSearch and palliAGED Engagement Project (www.caresearch.com.au/EngagementProject).

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