Subscribe Blog Contact
The views and opinions expressed in our blog series are those of the authors and are not necessarily supported by CareSearch, Flinders University and/or the Australian Government Department of Health.
Most people with advanced disease experience uncontrolled symptoms such as fatigue, pain or breathlessness, which can interfere with their daily lives. To help overcome these symptoms opioids are often prescribed for symptom relief to help patients, which enables them to do activities they were unable to do such as walking, climbing a flight of stairs and driving. Diana Ferreira discusses the importance for clinicians and researchers alike to critically consider the issues of driving and opioid use for people receiving palliative care.
For this discussion, aged care refers to the additional care required for an older person needing regular health professional input either in the community or in an aged care home.
Palliative care is, according to the WHO (World Health Organisation), ‘an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual’.
Chronic breathlessness is highly prevalent across the community. One in 100 Australians have significant impairment of their activities of daily living and one in 300 people are housebound because of breathlessness.
Chronic breathlessness is systematically under-recognised by health professionals. When taking a history about breathlessness, the question ‘are you breathless?’ is not going to elicit the problem nor its magnitude. ‘What do you have to avoid in order to minimise breathlessness?’ is a far more important question, or this can also be phrased as ‘what have you given up in order not to be breathless?’ With these questions, we start to get a picture of the net impact of breathlessness on individual patients.
People living with a life-limiting illness, such as cancer, frequently report moderate to severe pain and describe in detail how it affects activities of daily living and quality of life. What matters most – be it spending quality time with grandchildren, time in the garden, or writing down their favourite life anecdotes – becomes hard work and wearisome in the face of uncontrolled pain. Yet in managing this beast that is pain, management with opioids has its own share of issues. Fortunately, with some thought at the point of prescribing, whether initiating or reviewing therapy, general practitioners (GPs) can anticipate these issues. Here are five tips to improve confidence with opioid use in the terminally ill.