What palliative care means, in plain words
Palliative care is care for someone with a serious illness that will not be cured. Its aim is comfort. It tries to ease pain, breathlessness, sickness and worry, so that the person can live as well as possible for whatever time they have. It also looks after the family, because a serious illness touches everyone in the house.
The World Health Organization describes palliative care as an approach that improves the quality of life of patients and their families facing a life-threatening illness. It does this by spotting pain and other problems early and treating them, whether they are physical, emotional or spiritual.
Palliative care does not mean stopping all treatment, and it does not mean the end is close. The World Health Organization says it is most effective when it starts early in the illness, and that it can go hand in hand with other treatment. A parent having cancer treatment, or living with heart failure, kidney failure, lung disease or advanced dementia, can have palliative care for months or even years.
Families often come to us after a hard conversation at the hospital. A doctor has said that the illness cannot be cured, or that more treatment would do more harm than good. You may be wondering what happens now, and how to look after Mum or Dad at home. This page is for you.
Examples of palliative care
Palliative care is very practical. Much of it happens in small moments through the day. Some examples of what it looks like for an older parent:
- Pain relief that is prescribed and adjusted by a doctor, given on time, with someone noticing when it is not working
- Help to breathe more easily, such as sitting up, propping with pillows, a fan or an open window
- Medicines for nausea, constipation or restlessness, prescribed by the doctor and given as written
- Gentle washing, mouth care and keeping lips moist when eating and drinking become difficult
- Turning and positioning in bed to protect the skin and prevent pressure sores
- Small amounts of favourite food and drink, offered as wished and never forced
- Company, prayer, music, and time with family, in person or by video call
- Honest talk with the family about what is happening and what may come next
- Support for the family carer, who may be exhausted and frightened
Most of these do not need a hospital. They need trained people, a clear plan, a doctor who can be reached, and someone watching closely.
An example visit
An illustration. Your parent's nurse plans the actual times and tasks with you at the assessment.
- The caregiver arrives, clocks in on their phone at your parent's home, and hears from the night caregiver or family how Mum slept and whether she was in pain.
- A gentle wash in bed, mouth care to keep her lips and mouth moist and clean, and fresh nightclothes. The caregiver checks her skin for any red or sore areas.
- Morning medicines from the care plan are given exactly as prescribed and recorded. The caregiver asks Mum about her pain and notes it, along with any nausea or breathlessness.
- Mum is helped to change position in bed and propped up with pillows so she can breathe more easily. She wants only a few spoonfuls of pap and some sips of water, and that is fine.
- Quiet time. The caregiver sits with her, reads a psalm she likes, and sets up a video call so her son in Manchester can see her and talk to her.
- Mum seems more uncomfortable and restless. The caregiver reports it to our nurse straight away. The nurse tries to reach her doctor using the plan agreed at the start, and tells the family if she needs to be seen.
- Another change of position, more mouth care, and a short talk with her daughter about how she is holding up and when she last slept properly.
- The caregiver writes the visit report and hands over to the night caregiver. Our nurse checks and signs the report, and the family can read it online wherever they are.
Palliative care, end-of-life care and hospice: the difference
These words are often used as if they mean the same thing. They overlap, but they are not identical.
Palliative care is the wide term. It can start at any point after a serious diagnosis and can continue for a long time, alongside other treatment.
End-of-life care is palliative care in the last part of life. The NHS in the UK describes end-of-life care as support for people in the last months or years of their life, and says it is a form of palliative care given when someone is close to the end of life. The NHS also notes that this period is hard to predict and can last days, months or sometimes more than a year.
A hospice is a place, or a service, that specialises in this kind of care. In the UK and US, families often hear the word hospice when treatment has stopped and the focus is fully on comfort. In Lagos, hospice places are few, and many families choose to care for a parent at home.
Home Care Nigeria is not a hospice and does not run one. We are a nurse-led home care agency. We provide comfort and personal care at home, working with your parent's own doctor or hospital palliative team, who stay in charge of the medical side.
When is the right time for palliative care?
Earlier than most families think. Many people wait until the very last days, and then wish they had asked for help sooner. It is worth asking your parent's doctor about palliative care if any of these sound familiar:
- Your parent has an illness the doctors have said cannot be cured
- Pain, breathlessness or sickness is not well controlled
- Mum or Dad is spending more and more time in bed
- Eating and drinking have dropped off and they are losing weight
- There have been several hospital admissions in a short time
- Your parent has said they do not want more hospital treatment
- The family carer at home is worn out or cannot manage alone
- You live abroad and need someone reliable at the bedside and honest reports
If your parent does not yet have a palliative care team, ask the hospital that treats them whether it has one. Only a few hospitals in Lagos do, so you may need to ask the doctor for a letter and book the appointment yourself. If it does not, ask the consultant who will prescribe and adjust their pain relief and symptom medicines once they are home. Our nurse can help you think through these questions at the home assessment.
Palliative care at home or in hospital
Palliative care can be given in hospital, in a hospice or at home. The NHS lists all of these as places where end-of-life care can happen, and says the choice should reflect what matters most to the person. The World Health Organization also stresses home-based care, with families as part of the care.
Hospital makes sense when symptoms need treatment that can only be given there, or change so fast that a doctor needs to be close by. Many parents, though, would rather be in their own room, in their own bed, with family coming and going, familiar food, and their own church or mosque people able to visit. For many families in Lagos, home is where Mum or Dad wants to be.
Home also has hard parts. The family carer can become exhausted. Nights are long. It can be frightening to see symptoms change and not know who to call. That is where trained help at home makes a difference: someone who knows what to watch for, who keeps notes, and who has a nurse and a plan behind them.
If your parent has just come home from hospital and is weak or bedbound, our guide to caring for a bedridden parent covers the everyday basics.
How Home Care Nigeria provides palliative care at home
We provide palliative care at home alongside your parent's doctor or hospital palliative team. They lead on diagnosis and medicines. Our part is the daily care and close watching that keeps your parent comfortable between doctor's visits.
- Personal and comfort care: washing, mouth care, skin and pressure care, turning, and positioning to help with breathing
- Help with eating and drinking as your parent wishes, with no pressure to eat more than they want
- Keeping your parent calm and keeping them company, so they are not alone
- Watching and recording symptoms such as pain, breathlessness, nausea, restlessness and sleep
- Reporting changes to our nurse, who contacts your parent's doctor
- Day visits, night care, live-in care and respite cover, depending on what your family needs
- Support and practical guidance for the family, including the family carer
- A report after every visit, checked and signed by your named registered nurse and readable online by family anywhere
- Urgent alerts to the family, day or night, when something changes
Every client has a named registered nurse. Caregivers clock in on their phone at your parent's home and the location is checked. Before anyone works with a family, we check their identity document, a guarantor and two references.
Caregivers who work on palliative cases are trained in palliative and end-of-life care before they start. That training covers personal care for very ill people, pressure care, mouth care, recognising pain and distress, care in the last days of life, respectful care after death, and supporting the family.
We do not have a doctor on staff and we do not provide 24-hour nursing at the bedside. Your parent's medical care stays with their own doctor or palliative team, and our nurse works with them.
Pain relief and medicines
Good pain control is at the heart of palliative care. Strong pain relief and other symptom medicines are prescribed and adjusted by your parent's doctor or palliative team. Many strong painkillers are controlled medicines in Nigeria. The family usually has to collect them from a hospital pharmacy with the doctor's prescription, so it is wise to plan refills early. The World Health Organization notes that, around the world, strict rules and fears about misuse mean many people in pain cannot get the pain relief they need. That is one reason a doctor who can be reached quickly matters so much.
Our caregivers give only the medicines prescribed in the care plan, exactly as written, and record every dose. They never give injections. We do not prescribe, supply or manage controlled drugs ourselves.
What we do is watch closely. The caregiver asks your parent about pain at every visit, notices signs of pain in someone who can no longer say, and records it. Our nurse works with the doctor on the plan, checks whether symptoms are under control, and raises it quickly when they are not.
Getting started
Before care begins, our nurse visits your parent at home to assess them. Together with you and your parent's doctor, the nurse agrees how to reach the doctor or palliative team quickly, including at night, and what to do in an emergency. Everyone, including the caregiver, then knows the plan. Family abroad can join the assessment by video call. You receive a written care plan and quote within 48 hours.
We ask about your family's faith and cultural wishes early. Some parents want prayers said at the bedside, a pastor or imam to visit, or the family gathered. Some want to die at home, and some would rather be in hospital. These wishes are written into the care plan so that everyone respects them.
We cover Lagos Island and the Mainland. We do not publish prices, because the right plan depends on how much help your parent needs, whether you need days, nights or live-in care, and where they live. After the nurse's home assessment you receive a written care plan and quote within 48 hours. You can pay by card or bank transfer.
If your parent's situation is changing quickly, tell us when you get in touch and we will move as fast as we can.
The last days, and afterwards
In the last days, care becomes quieter and simpler. The caregiver keeps your parent clean, comfortable and turned, keeps their mouth moist, and stays close. If changes suggest the end may be near, we tell you, so that brothers and sisters abroad have the chance to fly home if they wish.
When your parent dies at home, call their doctor first. Some doctors will come to the house, but often the family has to take your parent to the hospital so a doctor can confirm the death and write the medical certificate of cause of death. The family then arranges the funeral home or mortuary. Our caregiver can stay with you, give respectful care to your parent's body, and help with what needs doing in the first hours.
Looking after a dying parent is exhausting, and grief does not wait until the end. We try to make sure the family carer gets rest, using night care or respite cover where it helps, and we talk honestly with you along the way.
