Supportive care for people with life-limiting chronic conditions is a newish “thing” that most people have not even heard of. So, what is it?
An article written by Dr Tracy Schumacher, Dr Josh Sher, Dr Bill Zhangchen, Asso. Professor Phil Tully, Lee Grant, Troy Arnold and Sarah Pullen
First, we need to look what a life-limiting chronic condition is, and how it might affect people. A person can live with a chronic disease such as heart failure or Parkinson’s disease for many years. Their experience is not always smooth – there might be long periods where everything seems OK, with some noticeable, but not too worrisome blips, and then some sudden and scary declines. Also, a person’s needs can be moving targets – just because one problem caused by their condition got solved once, it doesn’t mean that it stays solved, or that the same solution works next time. Symptoms can be complex, overlap and happen for many different reasons. This makes them difficult to predict and manage.
Ok, got it. What is the supportive care bit then?
Supportive care came from cancer care in the 1980s, where it was found that symptoms were better managed when treated holistically with a multidisciplinary team. The range of treatments can be much wider than pills and medicines.
Supportive care can take the form of one or more of these five broad pillars:
- Practical support
- Informational support
- Psychological support
- Social support
- Spiritual support.
Practical and informational support are evidence-based strategies that help people understand their condition and how to manage their symptoms. Our scoping review [1] found that clinicians commonly provide this kind of supportive care. Psychological support is often provided in chronic, life-limiting conditions for both the person with the condition and their significant others. Social and spiritual supports are also interwoven with psychological supports. Being a part of a community and society and getting meaning from life is important, especially since people can live with these conditions for many years. Spiritual support does not have to mean religious support – people can find life meaning through music, design, nature, art, relationships to others or an unlimited variety of other avenues. This helps to build resilience and support mental health and long-term well-being.
Although the terms supportive care and palliative care are often used interchangeably, we use supportive care here to describe care delivered over an indefinite period for conditions with an often uncertain trajectory. What distinguishes supportive care is its long-term nature – an acknowledgement that this is often a marathon, undertaken with only a partial map.
Supportive and palliative care teams may work with, or beside each other, but this can depend on the services involved. While both approaches focus on improving care in the later years or months of life, supportive care is typically introduced earlier in the disease course – any time following a life-limiting diagnosis. Its aim is to optimise quality of life for patients and support people through holistic, multidisciplinary care as the illness progresses toward the end of life.
What is the role of the multidisciplinary team?
Most people know about doctors and nurses in health care. However, there are many other healthcare professionals that can be called on to assist with symptom management in chronic conditions. Here are a few that can be used in supportive care – they work with and beside each other to minimise those sudden and scary dips.
Social workers, exercise physiologists, physiotherapists, dietitians, speech pathologists, pharmacists, podiatrists, occupational therapists and psychologists.
These healthcare professionals are known as allied health, and they can have a range of rather specialised skills. The best place to start if you might benefit from one of these professionals is your general practitioner (GP), if you don’t already have a chronic disease team or specialist. Your GP can work with you to see which might be the best mix of allied health professionals to reduce your symptom burden or who might be able to provide supports related to your condition.
Alternatively, some health districts are also developing their own models of supportive care [2,3], but they aren’t available everywhere in Australia yet. Your GP will be able to advise – they are always the best place to start.
Further reading
For clinicians aiming to provide supportive care services, our scoping review [1] provides an overview of what is reported in the literature, and whether enough information is provided for potential replication.
References:
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Sher J, Aradhya G, Lei A, et al. Supportive care in life-limiting, non‑malignant chronic disease: Scoping review. BMJ Supportive & Palliative Care [Internet]. 2025 Nov 9 [cited 2025 Dec 12]; Epub ahead of print.
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The Australian Council on Healthcare Standards. Quality Initiatives – Entries in the 25th Annual ACHS Quality Improvement Awards 2022. Sydney, Australia; 2022. Supportive care: What matters most? p. 5–16.
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The Australian Council on Healthcare Standards. Quality Initiatives – Entries in the 28th Annual ACHS Quality Improvement Awards 2025. Sydney, Australia; 2025. Mind & Matter: psychiatry in chronic disease. p. 101–111.
Authors
Dr Tracy Schumacher
Research Academic
University of Newcastle Department of Rural Health
Dr Josh Sher
Graduate of the Joint Medical Program
University of Newcastle / University of New England
Dr Bill Zhangchen
Graduate of the Joint Medical Program
University of Newcastle / University of New England
Associate Professor Phil Tully
School of Psychology
Deakin University
Lee Grant
Clinical Care Coordinator
Supportive Care for Chronic Disease Service, Hunter New England Local Health District
Troy Arnold
Social Worker
Supportive Care for Chronic Disease Service, Hunter New England Local Health District
Sarah Pullen
Health Service Manager,
Supportive Care for Chronic Disease Service, Hunter New England Local Health District