Foreword

Mā te huruhuru ka rere te manu.
Adorn this bird with feathers to enable it to fly.

Welcome to Te Puka Manaaki Pairuri o Aotearoa: Putanga Tuatahi – The Palliative Care Handbook New Zealand: First Edition. This edition has been extensively revised and, for the first time, includes guidelines to specifically support the provision of generalist palliative care in New Zealand.

The handbook provides guidance on what is both safe and expected palliative care practice within a non-specialist (generalist) palliative care setting. It is a handbook suitable for medical, nursing, and wider allied health practitioners who, in addition to their usual area of practice, also assess and make clinical decisions for patients who are deteriorating and require a palliative care approach.

Palliative care has come a long way from the inception of the modern hospice movement in the 1960s and marked by the establishment of the first hospice in New Zealand in 1979. Since then, palliative care has evolved into being an integral component of end-of-life care, addressing the needs of the whole person during their life-limiting illness and in their dying phase.

Our understanding of palliative and end-of-life care continues to deepen with an increased awareness of the importance of providing palliative care when and where it is needed. This often means the integration of palliative care earlier in the course of illness, extending beyond hospitals or hospice, and into the home and residential care setting. An important enhancement to the handbook is the consideration of wairuatanga or spiritual essence, an approach of particular importance for Māori but also to every person receiving palliative care along with their whānau-family. As clinicians and health professionals, acknowledging the spiritual needs of all patients transcends beyond the physical realm. Each chapter includes reflections from a patient or whānau-family “voice”. They are used in this book for the purpose of encouraging health professionals to consider aspects other than simply the medical condition or situation. The patient and whānau voice notations are taken from real comments shared with Hospice Kaimahi over the last two decades.

This edition also includes a new chapter on Caring for the older person. New Zealand has an ageing society, and we expect a significant increase in the number of older people who often have multi-complexity needs requiring palliative care.

The Syringe Driver Compatibility Chart has also been updated to reflect the most up to date use of two-drug combinations in New Zealand health settings.

Te Puka Manaaki Pairuri o Aotearoa – Putanga Tuatahi – The Palliative Care Handbook New Zealand – First Edition continues to support excellence in palliative care in New Zealand, as being a well-equipped resource for any health professional dedicated to delivering quality palliative and end-of-life care.

Dr Warrick Jones
Director of Clinical Services – Kaiwhakahaere Tākuta
Te Korowai Hūmārie – North Haven Hospice

Wayne Naylor
Chief Executive Officer
Te Kahu Pairuri o Aotearoa – Hospice New Zealand