The Palliative Care Team 

Palliative care teams are made up of professionals and volunteers with a keen interest in helping people die as comfortable a death as possible. Team members have training in end-of-life care and have chosen to work in this field. 

Who is On the Team? 

The teams may vary a bit according to place and service (home versus hospital), but the team's core is always the same. Team work is very important in any medical specialty, but it seems to be most important in the palliative care setting. The staff needs to work closely together and to communicate well with each other in order to provide the best possible care for the patients. 

Doctors 

In a hospital palliative care unit, the doctors are usually specialists in death and dying. They've had additional training in the many issues that confront a dying person and are focused not on healing the patient, but on providing treatment or therapy that can help the patient be more comfortable. 

Since the bulk of medical school is focused on saving lives, end-of-life care is a big change, and a challenge, from what doctors have learned. This is why it's not easy for a doctor with no palliative care experience to step into a palliative care environment. 

Medications used at the end-of-life are given in different dosages and at different time intervals than he or she would be used to in the regular medical environment, for example. And, of course, communication with dying patients is quite different than with one you are trying to heal. 

In home-care palliative care services, a patient's primary care doctor might continue to be the main doctor providing care, but there's usually a palliative care doctor, most often the director of the service, who provides back up and expertise in helping manage pain and other issues. 

Private palliative care residences may have either specialists or family doctors with specialist back-ups. 

Nurses 

Nurses who work in hospice or palliative care often have several years of experience working in other areas of medicine before settling in to palliative care. This experience gives them a certain level of life experience that seems to be appropriate for caring for dying patients. Some nurses don't have extra end-of-life training, but that's now changing as palliative care becomes a more mainstream medical and nursing specialty. There are now certificates and diplomas that nurses can work towards, geared specifically for palliative and hospice care. 

Nurses who go out to do home care work on their own with back up if needed. They visit according to the schedule worked out for each patient, depending on what type of care is needed and how often it should be done. 

Nurses who work in residences or hospital palliative care units work in teams with other nurses, providing the necessary care. 

Aides 

In many institutions, there are aides who help do work such as assisting patients with their meals, helping patients in and out of bed, and other similar tasks. In home care, aides may be the people who come in and help bathe or dress a patient. They generally visit more often than the nurses and are an important part of the team. Because they see the home care patients more frequently, they can report back any changes they've seen or anything that concerns them about a specific patient. 

Social Workers 

Social workers can play a large role in palliative and hospice care, both at home and in a residence or hospital unit. Before the palliative care begins, they can help find the placement or make arrangements for at-home care. They can help organize the financial arrangements or find funding for the care. 

Social workers are a good source for support - they can provide support themselves or they can tap into the community or hospital resource system to find patients what they need. 

Psychologists/Counselors 

A psychologist or counselor trained in death and dying can offer a valuable service to patients and family members. During the dying process, there may be many unresolved matters and someone who is properly trained in end-of-life issues can provide the assistance to help bring about resolutions. 

Religious or Spiritual Ministers 

For many people, end-of-life brings about thoughts about faith. They may become more spiritual or religious and want to speak to a minister of their faith. Having access to a minister or spiritual minister can help ease the last days of palliative care. 

Bereavement Counselors 

Palliative care doesn't end at the time of death. It continues on for the family and friends who have been left behind. The role of the bereavement counselor is to help with the grieving process and to provide support. 

Dieticians 

Not all palliative care teams have a dietician on board, but some do have this service to help them with their patients. A dietician can help come up with foods or drinks that someone at the end-of-life may enjoy and be able to eat or drink. 

Volunteers 

Often the unsung heroes of palliative care, volunteers play a large role on the team. In the hospital units or residences, as well as in private homes, volunteers can visit and provide entertainment or just a calming presence. If the spouse or caregiver of someone who is at the end-of-life doesn't want to leave him or her alone, a volunteer may be able to stay, allowing the caregiver to run errands or just have some time alone. In some places, volunteers run children's activity rooms to keep the children busy while one parent visits the other parent. The possibilities are endless when it comes to volunteering in palliative care.