Palliative Care

Cathy Payne, Max Watson

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


By the end of this chapter readers will be able to:- Describe the holistic principles of palliative care- Critically reflect on the ways in which nutritional support in the palliative care setting differs from other settings- Explain how patients nutritional goals will change with disease progression- Recognize the need for appropriate and timely review- Discuss and debate the ethical issues surrounding the provision of artificial nutrition and hydration- Critically reflect on the positive ways in which dietitians can help and support patients and their carers receiving palliative care
Original languageEnglish
Title of host publicationAdvancing Dietetics and Clinical Nutrition
EditorsAnne Payne, Helen Barker
ISBN (Print)0443067864
Publication statusPublished - May 2010

Bibliographical note

Reference text: 1. World Health Organization. National Cancer Control Programmes: policies and guidelines. Geneva: WHO; 2002

2. National Institute for Clinical Excellence (NICE). Guidance on Cancer Services: Improving supportive and palliative care for adults with cancer – the manual. London: NICE; 2004

3. Northern Ireland Cancer Network. A Framework for Generalist and Specialist Palliative and End-of-Life Care Competency. Belfast: NICaN; 2008

4. National Council for Hospice and Specialist Palliative Care Services. Definitions of Supportive and Palliative Care. London: NCHSPCS; 2002: Briefing Bulletin 11

5. Ellershaw, J. and Wilkinson, S. (eds.) (2003) Care of the dying: A pathway to excellence. Oxford: Oxford University Press

6. Thomas K The Gold Standards Framework. A framework for community palliative care. Online. Available: 6 Oct 2008

7. Department of Health. Building on the Best: Choice, Responsiveness and Equity in the NHS. London, HMSO; 2003

8. Souhami R, Tobias J. Cancer and its management 4th Edition. Oxford: Blackwell Publishing; 2003

9. National Council for Hospice and Specialist Palliative Care Services. Dilemmas and Directions: The future of Specialist Palliative Care. A discussion paper. London: NCHSPCS; 1997

10. National Council for Palliative Care. Focus on Commissioning. London: NCPC; 2007

11. Northern Ireland Cancer Network. Diagnosing Dying. Defining End of Life Care: A Position Paper. Belfast: NICaN; 2007

12. Saunders C. Care of the Dying – 1. The problem of euthanasia. Nurs Times. 1976; 72(26):1003-1005

13. Graham F, Clarke D. The Changing Model of Palliative Care. Medicine 2007; 36(2):64-66.

14. Thomas K. Palliative Care. Geriatric Medicine. 2006; 36(6):9-13.

15. World Health Organization. Davies E, Higginson IJ. Eds. The solid facts: palliative care. Copenhagen: WHO; 2004

16. National Council for Palliative Care. 20:20 vision: The shape of the future for palliative care. London: NCPC; 2005

17. Addington-Hall JM, Higginson I, eds. Palliative care for non-cancer patients. Oxford: Oxford University Press; 2001

18. Sinclair A, Dickinson E. Effective Practice In Rehabilitation: The Evidence Of Systematic Reviews. London: Kings Fund Institute; 1998

19. National Council for Hospice and Specialist Palliative Care. Fulfilling Lives. Rehabilitation in palliative care. London: NCHSPCS; 2000

20. Gold Standards Framework. Prognostic Indicator Guidance. NHS End of Life Care Programme. Online. Available: 18 Sep. 08

21. Maughan RJ. Impact of mild dehydration on wellness and on exercise performance Eur J Clin Nutr. 2003; 57(Supp 2):S19–S23

22. Hassall S, Gill T. Providing Care to the Elderly With Depression: the views of aged care staff. Journal of Psychiatric and Mental Health Nursing. 2008; 15:17-23

23. Caro MMM, Laviano A, Pichard C. Nutritional interventions and quality of life in adult oncology patients. Clin Nutr 2007; 26:289-301

24. Elmadfa I, Meyer AL. Body Composition, Changing Physiological Functions and Nutrient Requirements of the Elderly. Ann Nutr Metab 2008; 52(suppl 1):2-5

25. Carey I. Cancer Cachexia. Palliative Care Today 2000; 19: 20-22.

26. MacDonald N. Cancer cachexia and targeting chronic inflammation: a unified approach to cancer treatment and palliative/supportive care. J Support Oncol. 2007; 5(4):157-162

27. Alibhai SM, Greenwood C and Payette H. An approach to the management of unintentional weight loss in elderly people. CMAJ 2005: 172(6):773-780.

28. Richardson R, Davidson I. The contribution of the dietician and nutritionist to palliative medicine In: Doyle, D., Hanks, G. Cherny, N. And Calman, K. Oxford Textbook of Palliative Medicine. 3rd edn. Oxford: Oxford University Press; 2004:1047-1050

29. Aston T. Nutrition in palliative care: effective or ineffective? JCN Online 2006; 20(10):41-44

30. Davis MP, Dickerson D. 2000, Cachexia and anorexia: cancer’s covert killer. Support Care Cancer; 2000; 8:180-187.

31. Pennington CR. Disease-associated malnutrition in the year 2000. Postgraduate Med J. 1998; 74:65-71.

32. Haylett T, Johnston J. Palliative Care in the Community. Complete Nutrition; 2006; 6(1):14-16.

33. Barton AD, Beigg CL, MacDonald IA, et al. A recipe for improving food intakes in elderly hospitalized patients. Clin Nutr 2000; 19(6):451-454.

34. Hill D, Hart K. A practical approach to nutritional support for patients with advanced cancer. Int J Palliat Nurs. 2001; 7(7):317-21

35. Holder H. Nursing management of nutrition in cancer and palliative care. Br J Nurs. 2003; 12(11):667-674

36. Wallengren O, Lundholm K, Bosaeus I. Diet energy density and energy intake in palliative care cancer patients. Clin Nutr 2005; 24:266-273.

37. Walton K, Williams P, Bracks J, et al. A volunteer feeding assistance program can improve dietary intakes of elderly patients – a pilot study. Appetite 2008; 51:244-248

38. Powell-Tuck J, Hennessey EM. A comparison of mid upper arm circumference, body mass index and weight loss as indices of undernutrition in acutely hospitalized patients. Clin Nutr 2003; 22(3):307-312

39. World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. Geneva: WHO; 1995: Technical Report Series No. 854

40. Bray GA, Greenway FL, Molitch ME, et al. Use of anthropometric measures to assess weight loss. Am J Clin Nutr 1978; 31(5):769-73

41. Massarotto A, Carter H, Macleod R. et al. Hospital referrals to a hospice: timing of referrals, referrers’ expectations, and the nature of referral information. J Palliat Care. 2000; 16(3):22-29.

42. Findlay L, Hourston P, Kelly A, et al., Allied Health Professional services for cancer related palliative Care: An assessment of need. Allied Health Professions Palliative Care Project Team of the Glasgow Palliative Care Information Network 2004. Online. Available:

43. Northern Ireland Cancer Network (NICaN) AHP Integrated Care Pathways for Cancer NICaN: Belfast; 2007

44. Cherny NI. The problem of suffering In: Doyle D, Hanks G, Cherny N, Calman K. Oxford Textbook of palliative Medicine. 3rd edn. Oxford: Oxford University Press; 2004:7-14

45. Shragge JE, Wismer WV, Olson KL et al. Shifting to conscious control: psychosocial and dietary management of anorexia by patients with advanced cancer Palliat Med. 2007; 21: 227–233

46. Hopkinson JB, Wright DNM, McDonald JW, et al. The Prevalence of Concern About Weight Loss and Change in Eating Habits in People with Advanced Cancer. J Pain Symptom Manage. 2006; 32(4):322-331

47. Hopkinson JB. How people with advanced cancer manage changing eating habits. Journal of Advanced Nursing. 2007; 59(5):454-462.

48. Corben S, Rosen R. Self-management for Long-term Conditions. Patients’Perspectives on the Way Ahead. London: King’s Fund; 2005

49. Brooks M. Assessment in Palliative Care. In: Cooper J. Stepping into Palliative Care 2: Care and Practice. Oxford: Radcliffe Medical Press; 2006

50. Cooper J. Occupational Therapy in Oncology and Palliative Care 2nd edn. Chichester: Wiley; 2006

51. Poole K, Froggatt K. Loss of weight and loss of appetite in advanced cancer: a problem for the patient, the carer, or the health professional? Palliat Med 2002; 16:499-506.

52. Nourissat A, Vasson MP, Merrouche Y et al. Relationship between nutritional status and quality of life in patients with cancer. Eur J Cancer. 2008; 44(9): 1238- 1242

53. McClement SE, Harlos M. When advanced cancer patients won’t eat: family responses Int J Palliat Nurs. 2008; 14(4):182-188

54. Meares CJ. Primary caregiver perceptions of intake cessation in patients who are terminally ill. Oncol Nurs Forum. 1997; 24:1751-1757.

55. Hill FJ. Complementary and alternative medicine: the next generation of health promotion? Health Promot Int. 2003; 18(3):265-72.

56. Mercadante S, Fulfaro F, Casuccio A. The use of corticosteroids in home palliative care. Support Care Cancer 2001; 9(5):386-9

57. Loprinzi CL, Kugler JW, Sloan JA, et al. Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol. 1999; 17(10):3299-3306.)

58. Mateen F, Jatoi A. Megestrol acetate for the palliation of anorexia in advanced, incurable cancer patients. Clin Nutr 2006; 25:711-715

59. Nelson KA, Walsh TD. Metoclopramide in anorexia caused by cancer-associated dyspepsia syndrome (CADS). J Palliat Care. 1993; 9(2):14-8.

60. Blomstrand E, Eliasson J, Karlsson HK, et al. Branched-chain amino acids activate key enzymes in protein synthesis after physical exercise. J Nutr. 2006; 136(1 Suppl): 269S-73S

61. Bauer J, Capra S, Battistutta D, et al. Compliance with nutrition prescription improves outcomes in patients with unresectable pancreatic cancer. Clin Nutr 2005; 24:998-1004

62. Dewey A, Baughan C, Dean T, et al. Eicosapentaenoic acid (EPA, an omega-3 fatty acid from fish oils) for the treatment of cancer cachexia. Cochrane Database Syst Rev. 2007:1:CD004597.

63. Altun A, Ugur-Altun B. "Melatonin: therapeutic and clinical utilization". Int J Clin Pract 2007; 61(5):835–845.

64. Sanger GJ. Endocannabinoids and the gastrointestinal tract: what are the key questions? British Journal of Pharmacology 2007; 152:663–670

65. Lissoni P, Paolorossi F, Tancini G et al (1996). Is there a role for melatonin in the treatment of neoplastic cachexia? Eur J Cancer. 1996; 32A(8):1340–1343.

66. Persson C, Glimelius B, Ronnelid J, et al. Impact of fish oil and melatonin on cachexia in patients with advanced gastrointestinal cancer: a randomized pilot study. Nutrition 2005; 21|(2):170–178

67. Silverman WA. The Schizophrenic Career of a "Monster Drug". Pediatrics. 2002; 110(2):404-406

68. Gordon JN, Trebble TM, Ellis RD, et al. Thalidomide in the treatment of cancer cachexia: a randomised placebo controlled trial. Gut. 2005; 54(4):540-5.

69. Klausner JD, Makonkawkeyoon S, Akarasewi P, et al. Treatment with thalidomide in AIDS patients International Conference on AIDS. 1994; Aug 7-12; 10(1):221

70. Strasser F, Palmer JL, Schover LR, Yusuf et al. The impact of hypogonadism and autonomic dysfunction on fatigue, emotional function, and sexual desire in male patients with advanced cancer: a pilot study. Cancer 2006; 107(12):2949-57.

71. Basaria S, Wahlstrom JT and Dobs AS. Anabolic-Androgenic Steroid Therapy in the Treatment of Chronic Diseases J Clin Endocrinol Metab 2001 86(11): 5108-5117

72. Monroe B, Oliviere D. (Eds.) Resilience & Palliative Care: Achievement in Adversity. Oxford, Oxford University Press; 2007

73. Beauchamp TL, The ‘four principles’ approach to healthcare ethics. In: Ashford R, Dawson A, Draper H, McMillan J, Principles of Healthcare Ethics 2nd edn. Chichester: Wiley; 2007

74. Shaw S. Exploring the concepts behind truth-telling in palliative care Int J Palliat Nurs. 2008; 14(7):356-359

75. Mental Capacity Act 2005 HMSO, London

76. Ankeny RA, Clifford R, Jordens CF, et al. Religious perspectives on the withdrawal of treatment from patients with multiple organ failure. MJA. 2005; 183:616-621.

77. Gillick M. Artificial nutrition and hydration in the patient with advanced dementia: Is withholding treatment compatible with traditional Judaism? J Med Ethics. 2001; 27:12-15.

78. Koch T. The challenge of Terri Schiavo: Lessons for bioethics. J Med Ethics. 2005;31: 376-378.

79. Quill T, Byock IR. Responding to intractable terminal suffering: The role of terminal sedation and voluntary refusal of food and fluids: Position paper. Ann Intern Med. 2000; 132:408-414.

80. Van der Riet P, Good P, Higgins, IJ et al. Palliative Care Professionals’ Perceptions of Nutrition and Hydration at the End of Life. Int J Palliat Nurs. 2008; 14(3):145-151.

81. National Council for Palliative Care. Artificial Nutrition and Hydration: Guidance at the end of life. London: NCPC; 2007

82. Finucane TE, Christmas C Travis K. Tube feeding in patients with advanced dementia: a review of the evidence. JAMA; 1999; 282:1365–70

83. Higaki F, Yokota O, Ohishi M. Am J Gastroenterol. Factors predictive of survival after percutaneous endoscopic gastrostomy in the elderly: is dementia really a risk factor? 2008; 103(4):1018-20.

84. Koretz RL Do data support Nutrition support? Part II. Enteral Artificial Nutrition. J Am Diet Assoc. 2007; 107(8):1374-1380

85. Koretz RL, Avenell A, Lipman TO, et al. Does Enteral Nutrition Affect Clinical Outcome? A systematic review of the randomized trials. Am J Gastroenterol. 2007; 102(2):412-429.

86. Wijk H, Grimby A. Needs of elderly patients in palliative care Am J Hosp Palliat Care. 2007; 25(2):106-111

87. Mullard E. Presencing: the unseen therapeutic relationship In: Nyatanga, B and Astley-Pepper, M. eds Hidden Aspects of Palliative Care. London: Quay Books; 2005


Dive into the research topics of 'Palliative Care'. Together they form a unique fingerprint.

Cite this