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Specialist doctor for diagnosis/ investigations
Specialist nurse so I have someone to speak to at all times about their anxieties/worries
Family
District nurse to call upon for pain relief medications
Hospice team to lend support
councillor to enable me to off load any worries or concerns that can not be said to family
Faith leader to ensure my funeral wishes will be granted
Pain nurse to ensure i will suffer no pain

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doctors/specialists for diagnosis and investigations
nurses for care
counsellors/psychologists for emotional, psychological care for me and family
volunteers for support of charities and hospices
family for TLC

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Pat C
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My Palliative Care Team.

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A physiotherapist- to keep me going - so i can have some of the adventure team below.
My family- and support for my family like a drop in centre and key worker especially for the children.
The 'little' people so important- friends, receptionists, porters
An understanding GP- who understands palliative care
Someone to talk to- chaplain or counsellor, and help me plan funeral
Some people who understand and care- nursesOTS. May be from a hospice
Financial advisor to help me plan for those I leave
Knowing there is some support for those I leave behind
And importantly a key coordinator- does not matter what professional group but perhaps an occupational therapist or a social worker

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My team

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Just like cogs, I need each member to get things moving or accomplished. The family is in the middle as they need the professionals help to be the best support for their loved one.

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Care revolves around the patient and communication is between the providers and the patient

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FAMILY FRIENDS
LINK NURSE TO CONNECT ALL

MY TO DO LIST
MY CREATING MEMORIES LIST
MY WHAT IS IMPORTANT TO ME
MY WHAT HAPPENS NEXT...  WILL MY FAMILY BE OK

COUNSELOR  DOCTORS
PALLIATIVE SPECIALIST SPIRITUAL LEADER PHYSIO OT COMPLEMENTARY THERAPY GROUPS MAGGIE WALLACE MACMILLAN SOCIAL SUPPORT

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I've selected practitioners and people that are patient focused

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I would like to be able to do fun things hence the adventure team.

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I have put the patient and their family in their own bubble in the centre, because the family often need support from many of the other members of the care team, and the patient and family members will be supporting each other.  All the team members have input when needed to support the patient and their family, and all the team members are linked by a spiral line to indicate that they are all communicating and sharing information with each other.  This care could occur in a hospital, or more ideally, a hospice or at home. (The team members marked with a triangle, may not be needed/wanted by the patient in all cases).

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I've included a choice of hospice and home in the outer ring as there would be different supportive staff needs. All patients would receive both medical and supportive care and their family is involved in both of these elements. Ideally a specialist nurse is by their side for both elements as well, helping the patient and the family to navigate the rest of the network.

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MY TEAM                      PATIENT                         (main priority)                                                        Doctors   - hospice, hospital, palliative, GP.                          Nurses - palliative and                     non palliative                      teams                         psychologistFaith leaderFamilySocial workerTherapist - occupational /complementary

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MY TEAM                      PATIENT                         (main priority)                                                        Doctors   - hospice, hospital, palliative, GP.                          Nurses - palliative and                     non palliative                      teams                         psychologistFaith leaderFamilySocial workerTherapist - occupational /complementary

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Community teams - macmillian nurses, hospice at home, marie Curie

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Doctor+Nurses+ Palliative specialist+ Family Members
Faith leader+social worker
Friends+Physiotherapist+
Nutritionist

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Family Care + Doctor + Nurse + Volunteer ?? are my favourite team for Palliative Care at home

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The ideal multidisciplinary team to provide palliative care would comprise of counsellors, doctors, family and friends, carers, nurses, faith leaders, social workers and specialists.