Cheerful nurse comforting an old man lying in bed

The 5 Stages of Palliative Care: Why In-Home Nurse Support Matters

Palliative care is a type of compassionate care that focuses on providing relief from the symptoms, pain, and stress of a serious or terminal illness. 

Unlike hospice care, which is typically provided in the final stages of life, palliative care can be offered at any stage of a chronic or complex illness. The goal of palliative care is to begin to provide supplemental sources of support as early as possible, to maximize a holistic health experience. 

Let’s explore what palliative care is, the five stages of palliative care, and how in-home nurses can give families and clients greater peace of mind.

Definition of Palliative Care

Palliative care encompasses a multidisciplinary approach to managing the physical, emotional, and spiritual needs of people facing serious illnesses, such as cancer, heart disease, or chronic obstructive pulmonary disease (COPD). 

The goal of palliative care is to improve the quality of life for the person and their families by providing much-needed support during challenging health transitions. These services are provided by specialized team members, like private duty nurses, who address pain and other distressing symptoms, provide emotional support, and assist with decision-making related to medical treatment. 

What’s more, at-home palliative care welcomes the entire family into the process in a familiar environment for added comfort and security.

The Initial Assessment Process: What to Expect

The initial assessment is a critical step in palliative care at home, serving as the foundation for developing a comprehensive care plan tailored to the unique needs of each patient. During this stage, healthcare professionals, including in-home nurses, conduct a thorough evaluation of the patient’s physical, psychological, social, and spiritual well-being. 

This assessment helps identify symptoms, concerns, and goals of care, laying the groundwork for effective symptom management and support throughout the illness journey.

The assessment process typically begins with gathering detailed information about the patient’s medical history, current health status, and treatment preferences. In-home nurses work closely with patients and their families to establish open communication and trust, creating a supportive environment where all care team members feel comfortable expressing their needs and concerns.

Through empathetic listening and observation, private duty nurses gain insight into the patient’s overall condition, including any symptoms they may be experiencing, such as pain, fatigue, nausea, or anxiety.

Overview of the 5 Stages of Palliative Care

Palliative care is typically organized into five core stages, each of which plays a distinct role in supporting people and their families throughout their health journey. 

1. Advanced Care Planning

The first stage within the five stages of palliative care involves a comprehensive assessment of physical, emotional, and social needs. Healthcare professionals, including nurses, physicians, social workers, and therapists, work closely with you to identify symptoms, establish goals of care and develop personalized treatment plans. 

This plan should be co-created, meaning it is tailored to patients’ unique requirements and wishes. This plan will also address medications needed for the relief of symptoms and take into account one’s social, cultural, and religious preferences. 

Additional planning should also include discussion of code status. This allows a person to decide life-saving measures to be taken and open the dialogue with their family about their wishes. It may include the decision to exercise a do-not-resuscitate (DNR) order. 

This discussion is always important to have long before death is anticipated, so wishes are clearly expressed without emotional turbulence of any sudden changes in health. In this stable stage of at-home palliative care, patients may also be encouraged to ensure they have a Medical Power of Attorney and Living Will

The availability of a private registered nurse during this time is of utmost significance, as it ensures that all physical, medical, emotional, and psychological needs are fulfilled and comfort is prioritized. 

They can also help navigate some of these difficult decisions, as oftentimes not all members of the family are on the same page, and some discussions require someone else to help guide the conversation in a healthy way.

2. Planning & Preparing Emotionally

In this stage, healthcare teams should collaborate compassionately with patients and families to establish realistic goals of care based on the person’s unique preferences and values. This may include managing pain, improving mobility, enhancing quality of life, adjusting treatment plans, or achieving other specific outcomes.  

The private duty nursing team can also introduce certain chaplaincy services and other complementary therapies, including aromatherapy, pet therapy, soothing music, massages and saunas, and other relaxation practices like yoga and mindful meditation. The goal in this stage is to create a safe space to discuss emotions, thoughts, and concerns so individuals can process what is happening with other people they trust. 

3. Early-Stage Care

Once goals of care have been established, healthcare professionals, including in-home nurses, implement the care plan by providing various interventions, such as medication management, symptom management, wound care at home, and emotional support. 

At-home palliative care teams will introduce a few supportive adaptations in order to better manage conditions. These commonly include:

  • Adjustable beds
  • Ramps for wheelchairs
  • Relieving mattresses
  • Toilet support
  • Safety rails
  • Arrangement of at-home companionship

4. Late-Stage Care

Palliative care is dynamic, and a person’s needs may evolve over time. Therefore, regular monitoring and adjustment of the care plan are essential to keep it aligned with changing needs and goals. 

In this later stage of palliative care, discussions of hospice care at home may begin. This typically begins once the healthcare team feels that quality of life and overall physical well-being is becoming more difficult to manage. Typically, both the person and their family require more support, which can be provided in the home or in a facility. 

While hospice care is incredibly important, it is still not available 24/7 unless you choose an inpatient unit. This leaves the burden of care on the family, with short daily visits from hospice. Private duty nurses are available to fill in the gaps and can help provide care for a person and their family when hospice is not available. 

The presence of these nurses will help families just relax and be family, not caregivers — and this is an important part of the transition. 

5. End-of-Life Care

The hallmark of this stage is offering bereavement support and comfort to the person’s family and friends. This stage can last from anywhere between a week to a year. This end-of-life care at home is especially important for children who have lost, or will soon lose, a parent. 

Understanding the significance of these five stages of palliative care highlights the value of in-home nurse support in facilitating a smooth transition, promoting optimal comfort, and enhancing the overall quality of life for patients and their families.

The Importance of Private Duty Nurse Support for Palliative Care at Home

Private duty nurses play a vital role in conducting assessments, particularly in the context of at-home palliative care. Unlike assessments conducted in a hospital or clinic, home assessments offer a more holistic view of the patient’s daily life, environment, and support systems. 

In-home nurses can observe how people function in their own homes, identify potential barriers to care, and tailor interventions to meet the individual needs of each patient and their family.

Additionally, nurses provide valuable emotional support and education during the assessment process, helping patients and families navigate complex medical decisions and understand their options for care. 

By fostering a collaborative relationship with patients and families, nurses empower them to actively participate in their care and advocate for their needs.

Get Holistic In-Home Palliative Care from Navi Nurses

At Navi Nurses, we are committed to providing personalized, compassionate palliative care at home to Phoenix patients and families in the post-surgery vertical and beyond. Our team of dedicated in-home nurses is here to support you every step of the way, ensuring you receive the care and support you need to live life to the fullest, on your own terms.

For those in Maricopa County seeking end-of-life support for themselves or their loved ones, we invite you to explore our in-home palliative care services and discover the difference that compassionate, personalized nursing can make. Together, we can navigate the journey through serious illness with dignity, compassion, and peace of mind.

Want to learn more about how to implement co-created care and kickstart a rewarding nurse-patient relationship with our team of in-home RNs? We’d love to hear from you. Call us at (480) 630-0808 or reach out today.