Palliative care is often misunderstood — seen only as end-of-life care. But it’s much more than that. It’s about improving quality of life, staying connected, and helping people make empowered choices.
We spoke with Jacqueline Rapaic, Respiratory Nurse Educator at Respiratory Care WA, who has over 30 years of experience in respiratory health. Jacqui shares what a palliative approach really means, who it can help, and how health professionals can support people with compassion and confidence.
Q1. How does palliative care offer hope and support throughout the respiratory journey?
Jacqui:
It’s not just end-of-life care
Palliative care isn’t just for the final stages of illness. In respiratory care, it’s about improving quality of life at every stage — physically, emotionally, mentally, and socially. Our role as respiratory nurses is to be honest, kind, and compassionate. Sometimes that simply means listening. Other times, it’s about educating or making a timely referral to see their GP or Respiratory Physician to review their care plan or medications.
It’s also about empowering people to make choices that reflect what matters most to them whether that’s completing an Advanced Care Plan (ACP), an Advanced Care Directive (ACD) or connecting them with other health professionals who can support their journey.
Understanding the whole person
We use expert clinical judgement and evidence-based assessment tools to understand each client’s symptoms and how their condition affects their daily life and wellbeing. This includes their ability to work, drive, attend appointments, and spend time with family.
We also consider any co-existing conditions that may impact their health or care needs. Using these tools helps health professionals identify those at risk of deterioration — ensuring they receive timely and appropriate support.
Timely referrals are key
Making timely referrals is critical to ensure patients get the right support at the right time. Depending on their needs, this may include their GP, Respiratory Physician, Cardiologist, Pulmonary Rehabilitation (community or home-based), Dietitian, Social Worker (for home care, financial support, or living arrangements), Chronic Disease Coordinator, Mental Health Counsellor, palliative care services, or hospice.
”We are in a very privileged role to be part of this journey with the client. I feel sometimes we are the safe people for people to express their inner anxieties about where they are at in their lives. - Jacqui, Respiratory Nurse Educator
Q2. What is a ‘palliative approach’ to palliative care?
Jacqui:
It starts at diagnosis
A palliative approach is about supporting a person throughout their entire journey. Ideally it begins at the time of diagnosis. It doesn’t necessarily mean we discuss Advance Care Directives in the first appointment, although sometimes those conversations happen naturally. More often, it involves sensitive discussions that unfold over time, as we build trust and develop a connection with that person.
Over time we begin to uncover a person’s underlying concerns, their anxieties, hopes and goals. They may be struggling with their living situation, financial stress, or the physical toll of their condition. Others might feel isolated, frustrated, or anxious about the future. Understanding these concerns helps us provide care that is truly person-centred and meaningful.
Supporting families and daily life
Families are an important part of this journey. They often need clarity, and support to understand where their loved one is at, both medically and emotionally.
“I’ve had many calls where patients and families are on the same call and always aim to provide honest information about where they are at now.”
In addition to emotional support, we offer practical strategies to improve everyday life — such as breathlessness management and activity modification. These strategies help people stay active, feel productive, and maintain their emotional and mental wellbeing.
Q3. Who could benefit from a palliative approach to care?
Jacqui: Anyone with a chronic, life-limiting condition such as Chronic Obstructive Pulmonary Disease (COPD) can benefit from a palliative approach to palliative care. It’s not about hastening or postponing death. Instead, it’s about helping people plan their lives so they can maintain quality of life right through to the end of life.
”This approach is not there to hasten or postpone death but to help people plan their lives so they can have quality of life, right to the end.” - Jacqui, Respiratory Nurse Educator
Q4. How does Respiratory Care WA support patients and families with palliative care?
Jacqui: At Respiratory Care WA, we have an amazing team of nurses, educators, scientists and specialists who are here to provide expert clinical advice and are passionate about providing personalised educational support for people with a respiratory condition such as asthma and COPD. We can support patients with:
- Referral support to other health professionals such as GPs, Physicians, Mental Health Practitioners, Chronic Disease Coordinators etc.
- Person-centred approach to care
- Service offerings such as Lung Function Testing for regular reviews of lung function
- 1800 ASTHMA (1800 278 462) Helpline Support
- Individual education support (in person or via telehealth)
Q5. What advice would you recommend for health professionals supporting patients with palliative care?
Jacqui: I encourage health professionals to be kind, gentle, sensitive and most importantly to be good listeners. Take time to understand the patient’s respiratory condition and how it is progressing. Offer hope and never give up on them. Use your clinical expertise and intuitive judgement to provide care that is both evidence-based and person-centred.
”Changing the conversation around palliative care starts with understanding — and listening.
Whether you’re living with a chronic respiratory condition or supporting someone who is, early, compassionate conversations can make all the difference. As Jacqui reminds us, it’s never too early to focus on what matters most — living well, planning ahead, and feeling heard.
Featured resources / information
‘The Role of Palliative Care in COPD’ by Anand S Iyer, Donald R Sullivan, Kathleen O Lindell and Lynn F Reinke.
