Curriculum for General Practice - The Royal New Zealand College ...

End-of-life Care
E
End-of-life Care
End-of-life care is the active total care of
patients and their family/whānau at a time
when their disease is no longer responsive to
curative treatments. Control of pain and other
symptoms, addressing the person’s physical,
psychosocial, spiritual and cultural needs
and supporting family, whānau and other
caregivers is necessary to provide the best
quality of life for patients and their families. 1
End-of-life care involves ‘team care’ 2 and so thorough
assessment of symptoms and the needs of the patient
should be undertaken by a multidisciplinary team. The
general practitioner has a vital role to play in this team.
The World Health Organization 3 defines end-of-life care as:
An approach that improves the quality of life of patients
and their families facing the problem associated with
life-threatening illness, through the prevention and relief
of suffering by means of early identification and
impeccable assessment and treatment of pain and other
problems, physical, psychosocial and spiritual.
One of the essential roles of the general practitioner is to
help patients die with dignity and minimal distress. The
general practitioner must be able to identify such patients
in the last few months of life and importantly be able to
diagnose the state of dying. It is important that end-of-life
and palliative care is culturally appropriate and accessible
– currently, inequalities in access exist for some groups in
society including Māori and Pacific people. 4
1
Palliative Care Subcommittee and New Zealand Cancer Treatment Working Party. 2007. New Zealand Palliative Care: A Working Definition. Wellington: Ministry of Health.
2
Palliative Care Council of New Zealand and Cancer Control New Zealand. 2012. Measuring What Matters: Palliative Care. Wellington: Cancer Control New Zealand.
3
Word Health Organization. World Health Organization definition of palliative care. Geneva: World Health Organization. 2011. Available at www.who.int/cancer/palliative/
definition/en
4
Palliative Care Subcommittee and New Zealand Cancer Treatment Working Party. 2007. New Zealand Palliative Care: A Working Definition. Wellington: Ministry of Health.
www.rnzcgp.org.nz
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