What does a palliative care doctor do?

Dr Ruth Ting | Talking Death | Poppy's Funerals

Five minute read

Dying Matters Week next month (10-16 May) reminds us how talking openly about death can help people live fulfilling lives now and plan for their future. In her role as Consultant in Palliative Care at King's College Hospital NHS Foundation Trust, Dr Ruth Ting creates safe spaces for her patients to talk about life and death.

In this blog, she explains what a palliative care doctor does, what she has learnt from her patients and debunks some myths about palliative care.

First of all, can you briefly explain what palliative care is — and what your role as a palliative care specialist involves?

Palliative care is about finding ways to make life fulfilling and meaningful in spite of a life limiting or life-threatening condition. It’s helping someone to focus on the things that matter to them by trying to resolve the issues that might be preventing them from this such as physical symptoms, work or financial barriers, psychological/emotional, spiritual and social barriers.

My role as a doctor within the palliative care team is to assess someone in a holistic way and work with the person to resolve any issues. I introduce them to other members of the palliative care team who can help too. As a team, we walk alongside people and families for as long as needed. We try not to overstay our welcome and we become involved again when needed, including when someone is dying, to ensure they are comfortable and supported.

Why did you choose to work in this speciality and what do you find rewarding about it?

I’ve been working in palliative care since 2008. I love my job because every time I meet someone, it is an opportunity to help a fellow human being. It is a privilege also, to bear witness to the incredible resilience of my fellow human beings in face of suffering. My patients have taught me a lot about what it is to face life with grace and dignity.

What common misconceptions do people have about palliative care?

A common misconception is that palliative care means ‘giving up’ on life, or that we are there to compel them to think about death, to even compel them to stop having treatments that are prolonging their life. In fact the opposite is true, we are here to talk about life… what makes life worth living now, how do we maximise and enhance the things that make life worth living.

We support patients who are keen to continue treatments. However, for some patients who feel that treatments are compromising their quality of life, we can be there to help navigate life after treatments have stopped. Some people want to talk and plan for death and some prefer to take one day at a time. We understand and support people in whichever way that is most helpful for them.

In your encounters with people who are dying, their friends and families, are there any experiences that particularly stick in your memory?

There are many experiences and I’m struggling to find just one!

Very early in my training as a palliative care doctor, I met a woman who had cancer and who was in a lot of pain and wanted to stop treatments as she felt life was not worth living. We treated her pain as an out-patient at the hospice with strong painkillers, physiotherapy and occupational therapy.

Within a couple of weeks she was pain-free and had decided to persevere with cancer treatments again. She was once again gardening and able to play with her grandchildren. It was lovely to see her embrace life again! It really confirmed in my mind that I wanted to practice palliative care as a specialist.

Later on in my career, I looked after another gentleman who was extremely breathless with a chronic lung condition. He had grandchildren who were very close to him and had not seen him for a while. As he was dying, he became unconscious and his wife expressed how sad it was that their grandchildren could not come in to say goodbye, as the clinical environment might frighten them.

Over the next couple of days, we ensured he was comfortable and made the room less clinical and more ‘homely’. The social worker in our team talked to the parents of the children about how to prepare their children if they wished to visit. Some of the grandchildren came to see him and his wife really appreciated the time they could spend with him before he died.

I’ve had many more similar experiences which have convinced me that if healthcare teams work together to look after people in a holistic way, we are able to create a society that is kinder and more compassionate towards those who face suffering due to their health.

Palliative care involves working as part of a team with other health care professionals. How important is team-working for you in your role?

I could not do my best for a patient without our team. Palliative care team members have different skills, different viewpoints on how to resolve an issue and we all generally have a ‘can do’ attitude when it comes to problem-solving. So when faced with a complex issue, we can harness the strengths and knowledge of each team member.

The team also provide each other with moral and emotional support. The situations we encounter can be hard, so being able to talk about that with the team is invaluable. When I feel low and discouraged, the support of my team enables me to keep going but also to recognise when I need a break.

Check out these recommended sources of support from palliative care nurse Charity Garnett

What challenges has the Covid-19 pandemic brought to your work?

The greatest challenge I have found is the separation of patients from their families due to visiting restrictions.

Keeping vigil for families was nearly impossible in the first wave. In the second wave we had found ways to keep patients and visitors safe and to enable some families to keep vigil though is still limited in certain situations. We used technology such as video calling. We increased communication and updates to families by phone. But it did break my heart when goodbyes could not be said in person.

Poppy’s approach is to open up conversations about death and dying, so that people have the information and support that need to make the right decisions for them. How does this chime with the values behind a palliative care approach?

It chimes perfectly!

The palliative care approach is to create a safe space for a person to talk about what life’s like at the moment, what they want life to look like and how we can help. When a person feels safe sharing what is really going on in their lives they can then also feel safe talking about death and what they would wish for it to look like when the time comes.

Read more about why we need to talk about death and book here for our free, online panel on Thursday 13 May as part of Dying Matters Week.

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