6. Symptom management

Engage with all multidisciplinary team members to provide quality symptom management

Timely, effective, best-practice symptom management is fundamental in the provision of quality end of life and palliative care and must include engagement between primary healthcare providers, general practitioners, end of life and palliative care specialists and all multidisciplinary team members.

Action

Clear processes are in place to ensure there is provision of optimal, best practice physical, spiritual and psychological symptom management, as agreed by care providers, the person with the life-limiting illness, their family and carers. Processes are in place to review, respond and escalate if required, including case conferencing modalities.

Evidence

Appropriate symptom management is crucial to the health outcomes and experience of the person receiving care, their family and carers.

Considerations and resources

Matters regarding appropriate medication use, non-pharmacological considerations and rationalising treatments are important.

Useful resources can be found on the NSW Clinical Excellence Commission website, which includes the Last Days of Life toolkit, Medication prescribing for symptom management – Anticipatory Prescribing Guide and Symptom Management Flowcharts.

Resources

Comfort Observation and Symptom Management Chart (Adult)

Provides tailored individual symptom and comfort assessment and management for patients when their death is expected, as well as support to families and carers in managing symptoms.

Clinical Excellence Commission | Clinical tool | 2017

Last Days of Life Toolkit: Family/carer information regarding care in the last days of life

An information sheet for family and carers around what to expect when their loved one is dying.

Clinical Excellence Commission | Information | 2016

Last Days of Life Toolkit: Family/carer information regarding medications in the last days of life

An information sheet for family and carers around what to expect from medications, administered when their loved one is dying.

Clinical Excellence Commission | Information | 2016

Last Days of Life Anticipatory Prescribing Recommendations for in-patient setting (Adult)

An information resource for clinicians regarding anticipatory prescribing of medications in the last days of life.

Clinical Excellence Commission | Clinical tool | 2017

Medication prescribing

Flowcharts that assist in the assessment and management of the five symptoms commonly experienced by patients in the last days of life.

Clinical Excellence Commission | Clinical tool | 2017

HealthPathways in Pallliative Care and Advance Care Planning

Clinical tools which are designed and written for use during a consultation, that provides clear and concise guidance for assessing and managing a patient with a particular symptom or condition.

End of Life Directions for Aged Care | Toolkit | 2020

Palliative Care Outcomes Collaboration: Assessment forms

Symptom assessment tools designed to help clinicians identify and manage common symptoms at end of life.

University of Wollongong | Clinical tool | 2021

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