There are many health-care providers that may care for you along your illness journey. Those involved in your care will differ depending on your own unique needs, the needs of your family and the location of your care.
The palliative care team is here to:
- help you understand your illness so you can make informed decisions;
- ensure pain and symptoms are well controlled with medications and other techniques;
- ensure you and your family/caregiver(s) have the physical, emotional and spiritual support you need to feel as well as you can throughout your illness journey;
- ensure your family and caregiver(s) have the knowledge and skills to support and care for you throughout your illness, and;
- help ensure that you receive care in a setting that is right for you and your family.
Doctors and nurse practitioners
You may see a variety of doctors and/or nurse practitioners over the course of your illness, including your family doctor, or a specialist such as an oncologist or cardiologist.
Your family doctor or specialist may also refer you to the palliative care consult service/pain and symptom management team. This team consists of doctors and nurse practitioners that have specialized training in managing pain and other symptoms that are common in life-limiting illness. For more information, please visit the Palliative Care Consult Service page.
You may see nurses in many different settings over the course of your illness, including community health nurses (CHN), palliative care consult nurses or a palliative care nurse navigator, as well as nurses in hospital and long-term care settings.
Community health nurses
The community health nurse is an important member of the palliative care team and works closely with other members of the care team.
The community health nurse:
- can visit you in your home, in a community clinic or virtually (phone or telehealth);
- will do a detailed assessment of your care needs;
- can help to arrange any equipment, supplies or home supports that you may need;
- can provide you with information about your illness; and
- can connect you to other resources that may be helpful.
They can also provide education on managing pain and other symptoms and help to ensure you know how to safely take your medications.
Palliative care consult nurses/palliative care nurse navigator
Palliative care consult nurses and the palliative care navigator are nurses with specialized training in palliative care.
They are part of the palliative care consult service/pain and symptom management team.
Palliative care consult nurses/palliative care nurse navigator will:
- work closely with the palliative care doctors and/or nurse practitioner to coordinate your initial appointment and any necessary follow-up;
- follow-up with you by phone and or in-person;
- help to coordinate any other services you may need (such as a community health nursing or social work referral);
- help to answer any questions you may have about your illness or managing your medications.
Nurses in hospital settings and long-term care
If you have an admission to hospital, to the Palliative Care Unit (PCU), or are a resident in a long-term care facility, a registered nurse (RN) and/or a licensed practical nurse (LPN) will care for you.
The RN/LPN will assist you with personal care, provide medications as prescribed by the doctor/nurse practitioner, ensure you are comfortable and answer any questions you or your family may have about your illness and what to expect.
Social workers practice in community settings, hospitals, and long-term care facilities. There are also social workers who have special training and experience in palliative care.
They can provide you and your family with emotional and psychosocial support through individual or family counselling and can also connect you with extra supports and resources in the community.
Occupational therapists work with individuals to help improve and/or maintain their ability to perform activities of daily living whether at home, at work and/or in the community.
They will work with you, your family, and your health care team to help you identify and meet your goals and to help you be as independent and as safe as you can be.
This may involve evaluating your physical or emotional needs, or examining your environment to see if changes can be made to help you function more easily and effectively. These changes may include trying equipment such as wheelchairs, special cushions or mattresses, assistive or adaptive devices, and other items.
Physiotherapists have specialized clinical knowledge and skills to assess and treat the physical symptoms of illness, injury and disability.
Physiotherapists play an important role in palliative care by:
- recommending equipment that can help improve or maintain mobility and independence for as long as possible;
- assisting with exercise, positioning and other techniques to alleviate common symptoms such as pain and shortness of breath;
- implementing strategies to reduce the risk of falls and fall related injuries; and
- providing education to ensure your family and caregivers have the knowledge and skills to help to care for you safely.
Pharmacists work closely with other members of your health care team to ensure that you are receiving the best medications to help you manage pain and other symptoms.
Pharmacists can also help to ensure that there are no harmful interactions between your medications and can teach you and your family/caregivers how to take and store your medications safely.
Weight loss and decreased appetite are common in life-limiting and serious illness. Registered dietitians can give you advice and answer questions or concerns you may have about eating, diet and health.
Speech language pathologists
The role of the speech language pathologists (SLP) in palliative and end-of-life care is primarily related to assessing swallowing abilities and providing recommendations to promote safe eating and drinking.
The SLP can monitor changes in swallowing function and modify treatment plans that may aim to:
- maintain pleasure while eating and drinking;
- reduce the risk of choking and breathing complications;
- promote regular mouth care to reduce discomfort;
- respect and support patient or client choices related to eating and drinking.
SLPs can also address issues related to communication difficulties such as challenges understanding language or trouble with speaking.
Pastoral and spiritual care
At Eastern Health, we respect all religious affiliations and welcome clergy of all faiths. Pastoral care clinicians provide pastoral care and spiritual support to clients and families in a variety of settings including community, hospital, long term care and the palliative care unit.
Visit the Pastoral Care section to learn more.
Home support workers/personal care attendants
Home support workers and personal care attendants (PCAs) play an important role in palliative and end-of-life care in community, long-term care and residential care settings.
Home support workers provide personal and behavioural support, assistance with household management and caregiver respite. Home supports are delivered by an approved home support agency or by a home support worker hired by the individual or family.
PCAs typically work in residential care settings such as personal care homes and long-term care facilities and assist with activities of daily living such as bathing, dressing, grooming, meals and mobility.
Therapeutic recreation provides a variety of recreation services to you on an individual or group basis to enhance your cognitive, social, physical, emotional and spiritual health.
Recreational therapy is more common in residential care settings.
Community Paramedicine provides a palliative care program within the St. John’s metro region, which includes Pouch Cove to Witless Bay. In this program, trained paramedics provide patients with urgent pain and symptom management in the home, assistance in navigating the healthcare system as it relates to palliative care and reassurance for patients and families.
This service is available for :
- Pain and Symptom Management/Palliative Care – Dr. L.A. Miller Centre;
- Palliative End of Life Care Community Services;
- the Home Dementia Program; and
- Geriatric Medicine
Clerical staff work closely with other team members and have many important roles in your care, including registration and booking of appointments. Clerical staff work closely with other team members to make sure everything is ready for your visit.
Volunteers are integral members of the palliative care team. They assist with providing tours of the area, friendly visiting and entertainment. In addition, in some facilitates, such as the palliative care unit, volunteers offer a pet therapy program.
If you are interested in volunteering, please visit the Volunteer Resources Section to learn more.