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Palliative Care 

Palliative care  


'Palliative and end of life care are integral aspects of the care delivered by any health or social care professional to those living with and dying from any advanced, progressive or incurable condition. Palliative care is not just about care in the last months, days and hours of a person’s life, but about ensuring quality of life for both patients and families at every stage of the disease process from diagnosis onwards.

A Palliative care approach should be used as appropriate alongside active disease management from an early stage in the disease process.  Palliative care focuses on the person, not the disease,Palliative care focuses on the person, not the disease  and applies a holistic approach to meeting the physical, practical, functional, social, emotional and spiritual needs of patients and carers facing progressive illness and bereavement.'

from LIVING AND DYING WELL
a national action plan for palliative and end of life care in Scotland

 

‘Palliative care' is the term used to describe the care that is given when cure is not possible. The word comes from the Latin 'palliatus' (covered or hidden with a cloak) and is used to mean 'relieving without curing'.

Palliative care is a proactive approach involving a multi-professional team. As well as controlling pain and other distressing symptoms, it applies a holistic approach to meeting the physical, practical, functional, social, emotional and spiritual needs of patients and carers facing progressive illness and bereavement.

Although historically associated with the later stages of cancer, it is now established that palliative care should also be a routine part of care for those living with and dying from a wide variety of non-malignant conditions, such as dementia, heart failure, Huntington's disease, motor neurone disease, multiple sclerosis, muscular dystrophy, Parkinson's disease, renal failure and respiratory failure among others.

Palliative care can be provided at any stage following diagnosis of a life-limiting illness or condition, and not solely in the last few days, weeks or months of life. A palliative care approach should be used as appropriate alongside active disease management from an early stage in the disease process.

The World Health Organization offers the following definition of palliative care:

"Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care provides relief from pain and other distressing symptoms;

  • affirms life and regards dying as a normal process;
  •  intends neither to hasten or postpone death;
  •  integrates the psychological and spiritual aspects of patient care;
  • offers a support system to help patients live as actively as possible until death;
  • offers a support system to help the family cope during the patients illness and in their own bereavement;
  • uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
  • will enhance quality of life, and may also positively influence the course of illness;
  •  is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications."

Depending upon a person's needs, different levels of palliative care may be provided by a number of different people and services:

General Palliative Care

General palliative care is an integral part of the routine care delivered by all health and social care professionals to those living with a progressive and incurable disease, whether at home, in a care home, or in hospital.

General palliative care is care that is based on the understanding and practice of palliative care principles. These include:

  • a focus on quality of life which includes good symptom control
  • a whole person approach which takes into account the person's past life experience and current situation
  • care which encompasses both the person with the life-threatening illness and those that matter to that person respect for patient autonomy and choice emphasis on open and sensitive communication

Specialist Palliative Care

Specialist palliative care is based on the same principles of palliative care outlined above, but can help people with more complex palliative care needs. Specialist palliative care is provided by specially trained multi-professional specialist palliative care teams and can be accessed in any care setting.

Scottish Partnership for Palliative Care