Palliative Care service and referral details

Clinical service overview

When to consider palliative care

Palliative care is an approach which improves the quality of life of patients and their families who are facing the problems 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.

When to refer to specialist palliative care

Only a small proportion of patients need to be seen by a palliative care medical specialist. Most can be managed by their general practitioner and their existing specialists – for example oncologist, general physicians and geriatricians. However, many patients may benefit from the nursing/social/psychological support provided by a community palliative care nursing service.

Palliative Care Victoria provides information about finding a local palliative care service by postcode. Those patients for whom advice from, or review by, a palliative medicine physician may be useful include:

• Refractory symptom management including pain control, nausea/vomiting, constipation, delirium etc
• Assistance with end of life decision making (i.e. withdrawal of treatment, artificial hydration etc)
• Advanced care planning
• Management and referral to community services for patients and/or carers with profound existential distress, grief or bereavement issues

The psychological problems that palliative patients can experience include anxiety, depression, and existential distress. Existential distress refers to issues such as: “Why me? What is the purpose of my life? Did I achieve all that I could have? What does death mean? It's not fair?”

The palliative care team (including our nurses and grief counsellor) are trained to help people navigate a way through these difficulties.

Community services

Community services form a critical component of palliative care for patients in the community. 

These services include GPs as well as community palliative care teams:

• Calvary Health Care
• Calvary Health Care Bethlehem
• Peninsula Home Hospice
• Eastern Palliative Care
• Mercy Palliative Care
• Melbourne City Mission
• South East Palliative Care

We also liaise with Barwon Palliative Care and other regional services.

Community services, both specialist palliative care teams and general visiting nurses such as Bolton Clarke also play a key part in providing palliative care for patients in the community. They are able to do home visits (including support in residential aged care facilities) and have close links with hospices.

Victoria has a wonderful community-wide set of services to cover all areas, regional and metropolitan. Patients may be referred directly to these services by a family member or their GP.

Exclusion criteria

This service does not routinely provide treatment for the following:

• Patients who are already linked with another palliative care physician or clinic
• Patients who are not known to or undergoing treatment at Alfred Health. Consider referral to Calvary Health Care Bethlehem
• Patients with chronic, non-malignant pain are usually not suitable for review in the Palliative Care Clinic. Contact one of our consultants if you would like to discuss this
• Children under 18 years of age are generally not seen at The Alfred. If you are referring a patient under the age of 18, please visit the Victorian Paediatric Palliative Care Program.

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