The RACGP’s 2024 Silver Book Part A notes that palliative care is a fundamental component of general practice. GPs are well placed to support patients across the illness trajectory supporting transitions from chronic disease management to treatment of advanced illness, to a palliative approach, end-of-life care and care during dying.
'palliative approach shifts the primary focus from life-prolonging treatments towards symptom treatment and quality of remaining life.'
'End-of-life care is focused on providing increased services and support for the person’s physical, emotional, social and spiritual/existential issues as they approach death.'
Definitions from RACGP 2024 Silver Book
Palliative Care Australia's National Palliative Care Standards for All Health Professionals and Aged Care Services acknowledge the vital contribution of those not working in specialist palliative care who provide generalist palliative care. These standards note that all healthcare providers who provide care to people living with a life-limiting condition, their families and carers should have minimum core competencies in the provision of palliative care and understand the palliative approach to care.
Communication
Clear communication with the person and their family allows them to plan and make decisions in line with their preferences and situation. Communication requires skills in giving and receiving information, but for many people discussing end-of-life issues can be a challenge. Knowing how to start the conversation can help.
Vital Talks has examples of phrases that can be used when Disclosing bad news. They also have a talking map to guide Discussing Prognosis and changing goals of care and a series of 5 videos. The PREPARED model (186kb pdf) is a guide for clinicians on holding conversations about the last days of life.
CareSearch has a GP resource on communicating with patients and families.
You can also download the CareSearch factsheet Starting palliative care conversations: For health professionals (172kb pdf).
You can order copies of the CareSearch Patients and Carers booklet to give to older people and their families.