Episode 103: Modern Palliative Care: its Evolving Role, Individualised Prescribing and Honest Conversations at the End of Life

In this episode, Dr Bryony Alderman, palliative care consultant and RCP sustainability clinical education fellow, joins Dr Vasiliki Thanopoulou, rheumatology registrar and RCP clinical education fellow, for a wide‑ranging discussion demystifying modern palliative care.

Together they explore how the specialty has evolved beyond end‑of‑life support, highlighting early integration, symptom management across disease groups, and the importance of compassionate, individualised care.

The conversation dives deep into practical clinical considerations: appropriate timing of referrals, anticipatory prescribing, managing medications in renal/hepatic failure, handling chronic disease therapies at the end of life, and common misconceptions around syringe drivers. They also discuss communication challenges, including uncertainty in prognostication, hydration and nutrition decisions, and supporting families during difficult conversations.

This is an essential episode for clinicians looking to enhance confidence and skill in end‑of‑life care, while keeping person‑centred care at the heart of practice.

Resources 

https://www.spict.org.uk/

Lee C, Tran TT, Ross J Anticipatory prescribing in community end-of-life care BMJ Supportive & Palliative Care 2024;14:353-357

https://www.parkinsons.org.uk/professionals/resources/nil-mouth-medication-dose-calculators-and-guidelines

https://www.diabetes.org.uk/for-professionals/improving-care/clinical-recommendations-for-professionals/diagnosis-ongoing-management-monitoring/end-of-life-care

https://www.nacel.nhs.uk/about-nacel

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