If not already underway, referral to palliative care should be considered at this stage (including nursing, pastoral care, palliative medicine specialist backup, inpatient palliative bed access as required, social work, psychology/psychiatry and bereavement counselling), with general practitioner engagement.

If not already in place, the patient and carer should be encouraged to develop an advance care plan (AHMAC 2011).

The palliative care team may consider seeking additional expertise from a:

• pain service
• pastoral carer or spiritual advisor
• bereavement counsellor
• therapist (for example, music or art).

The team might also recommend accessing:

• a respite specialist
• home- and community-based care
• specialist community palliative care workers
• community nursing.

Consideration of an appropriate place of care and preferred place of death is essential.

Occupational therapy home assessment is also essential to ensure palliative patients receiving home-based care are managed safely.

Ensure carers and families receive information, support and guidance regarding their role according to their needs and wishes (Palliative Care Australia 2005).

Further information

Refer patients and carers to Palliative Care Australia.