Palliative care

People with chronic respiratory disease often suffer from a high symptom burden, level of disability and uncertainty about their future. However, individuals with non-malignant disease receive far less palliative care than those with cancer. The unmet need for palliative care may be improved be considering its role alongside PR as a mainstay of respiratory care. Palliative care should be integrated early, based on need rather than prognosis. Early identification and assessment of palliative care needs is, therefore, vital. Areas where palliative care could bring added benefit include management of chronic breathlessness, advance care planning, and psychosocial support for the patient and family. Practical opportunities needed to include palliative care into PR include: 1) building knowledge of both specialities and advocacy among clinicians; 2) referring onwards where appropriate; 3) providing educational content for programmes; 4) training and upskilling clinicians in symptom management and advanced communication; 5) facilitating support groups; and 6) in-reach consultation for individual cases.