The term, however, applies to caring for all dying patients, whether they are dying from cancer, end-stage coronary heart or renal disease, HIV, or motor neuron disease.
The Department of Health launched its End-of-life Care Programme in 2003 to improve the quality of care at the end of life for all patients. Part of this programme involved training (mostly community nurses) in skills to enable them to support specialists in caring for a wider patient group.
Targets have been set to have various tools in place across different settings in the NHS, such as a ‘gold standard for palliative care’ to improve good practice in palliative care in the community in all GP practices around the country, and the Liverpool Care Pathway, a guidance document for transferring the hospice model of care into other care settings.
Palliative care for people with cancer is provided from many sources. The charity Macmillan Cancer Support provides funds for Macmillan nurses. Macmillan pays the salaries of these nurses for three years and then the NHS takes over their funding, although they often continue to be known as Macmillan nurses.
There are around 2,500 Macmillan nurses, all of whom are fully qualified nurses with at least five years of nursing experience, including two or more years caring for people with cancer or other terminal illness. Most of them are based in the community and see patients at home but some work in hospitals or hospices.
Their work includes explaining to patients the best way to control pain and other symptoms, advising them about different treatments available, helping them with the control of side-effects, spending time with patients and their families to give emotional and psychological support, and advising on ways of getting practical help, such as advice on benefits.
Macmillan nurses are there to help people at any point after a cancer has been discovered and not just for people who are terminally ill or dying.
Marie Curie Cancer Care is another charity that provides support and care for people who have cancer. Their nurses provide hands-on home help for people in the end stages of life and will stay overnight if necessary to give relatives a break.
These nurses are specialists in controlling symptoms and can help at any stage of cancer. Part of their work is to liaise between patients, relatives, GPs and the hospital to improve the quality of life for the whole family.
Updated: September 2006