Does starting palliative care mean stopping treatment?
No.
No. Starting palliative care does not automatically mean stopping treatment. Many people have palliative care while they still receive active treatment for their illness. Palliative care focuses on comfort, quality of life, symptoms, decisions and support.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Palliative care can sit beside other treatment
Healthdirect and Cancer Council Australia both explain that palliative care can be provided alongside active treatment. This means a person might receive palliative care while also having cancer treatment, heart or lung treatment, kidney care, antibiotics, surgery, radiotherapy or other treatments.
Sometimes the active treatment is still trying to control the illness. Sometimes it is mainly trying to ease symptoms. Palliative care helps the person and their family understand what each treatment is meant to do and whether it fits the person's goals.
What may change
Starting palliative care may change the focus of conversations. The team may ask:
- What matters most to the person now?
- Which symptoms are causing the most distress?
- What treatments are helping?
- What treatments are causing harm or taking too much energy?
- Where would the person prefer to be cared for, if possible?
- Who should make decisions if the person cannot speak for themselves?
These questions do not force a person to stop treatment. They help the person make choices with clearer information.
Treatment can have different aims
Treatment is not only "cure or nothing". A treatment may aim to:
- cure the illness
- slow the illness
- shrink or control cancer
- relieve pain, pressure or bleeding
- reduce breathlessness
- prevent a distressing complication
- help the person stay at home longer
For example, radiotherapy may be used to ease pain from cancer in a bone. Surgery may be used to relieve a blockage. Antibiotics may be used if an infection is causing distress and treatment matches the person's goals.
The same treatment can have different aims for different people. Ask the treating team to explain the aim in plain language.
When treatment might be stopped
Some treatments may be stopped later if they are no longer helping, if side effects are too heavy, or if the person decides they do not want them. This should be discussed with the treating team.
In Australia, adults with decision-making capacity generally have the right to accept or refuse medical treatment. The details can depend on the decision, the person's capacity and state or territory law. If the person is unsure, they can ask for time, a second opinion, or a family meeting with the treating team.
Stopping one treatment does not mean stopping all care. Comfort care, nursing care, medicines for symptoms, emotional support and family support can continue.
Does palliative care mean the doctor has given up?
No. Palliative Care Australia says palliative care can be given with active treatment and can help people meet their goals of care. The care is still active. It may involve close symptom review, medicine changes, equipment, home visits, counselling, practical support and planning.
The phrase "nothing more can be done" is usually not accurate. Even when an illness cannot be cured, there are often things that can be done to help comfort, dignity, communication and support.
Questions to ask the team
Useful questions include:
- What is the aim of this treatment?
- How likely is it to help?
- What side effects or burdens should we expect?
- What happens if we continue it?
- What happens if we stop it?
- Can palliative care be involved while treatment continues?
- Who do we call if symptoms worsen at home?
- Can we have a family meeting to talk this through?
Writing questions down before an appointment can help, especially after a difficult diagnosis.
When to get help now
Contact the person's doctor, specialist, palliative care team or nurse if symptoms are not controlled, side effects are severe, or the person is thinking about stopping a treatment and needs advice.
Call 000 if there is a life-threatening emergency, such as severe breathing distress, severe uncontrolled bleeding, a sudden collapse without an expected death plan, a major injury, or immediate danger.
You may also want to read
- When should palliative care start?
- How do I actually get palliative care?
- We've just been told the illness is terminal. What happens next?
- What should we organise after being told someone may only have months to live?