What is Palliative Care?
WHO Definition of Palliative Care
Palliative care is an approach that improves the quality of life of patients and their families facing the problems 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.
WHO Definition of Palliative Care for Children
Palliative care for children represents a special, albeit closely related field to adult palliative care. WHO’s definition of palliative care appropriate for children and their families is as follows; the principles apply to other paediatric chronic disorders (WHO; 1998a):
- Palliative care for children is the active total care of the child`s body, mind and spirit, and also involves giving support to the family.
- It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease.
- Health providers must evaluate and alleviate a child`s physical, psychological, and social distress.
- Effective palliative care requires a broad multidisciplinary approach that includes the family and makes use of available community resources; it can be successfully implemented even if resources are limited.It can be provided in tertiary care facility.
What is the Goal of Palliative Care?
The goal of palliative care is to achieve the best possible quality of life for patients, their families and carers. The focus of palliative care is on increasing comfort through prevention and treatment of suffering.
Palliative Care versus Hospice Care
Hospice is the most known kind of palliative care, which was originally developed to care for people at the end of their lives. This concept of care has expanded since then to encompass palliative care that should start at diagnosis. True palliative care should start with diagnosis, but can be provided at any time during the course of illness, along with curative therapies meant to prolong life, for example, in hospital concurrently with chemo- and/or radiotherapy and at primary health care level in conjunction with antiretroviral therapy. The palliative approach helps the health care professional to recognise all the care needs of a person from the time of diagnosis, determine the stage in a person’s illness when palliative care services are needed, as well as deciding on when to start discussing referral to a palliative care organisation with a dying person and their family.
This is a holistic approach to care, informed by the knowledge and practice of palliative care principles, which promotes a person’s physical, psychological and social wellbeing. It can also be provided at a person’s own home, the home of a family member, or a nursing home. The goals of care are the same regardless of where a person receives it.
The provision of palliative care should be guided by referral protocols, supported by the advice of a health care professional and most importantly be based on the person’s needs and choices. It is important that the person receive appropriate support and clinical care provided by palliative care and other resources as described above until cure or death.
Who can Benefit from Palliative Care?
Anyone who has a life-threatening illness can benefit from and should have access to palliative care. In the past palliative care programs only cared for cancer patients, but this has now changed to include caring for people with all kinds of life-threatening illnesses, for example, heart disease, chronic obstructive pulmonary disease, HIV/AIDS and Multiple Sclerosis.
All people who are suffering from life-threatening disease who could benefit from palliative care should have timely access to quality palliative care services that are culturally appropriate and are provided in a coordinated way. Since palliative care is a holistic approach which considers physical, psychosocial and spiritual issues, families of patients can also benefit from palliative care, especially when being supported during bereavement.
Evidence shows that palliative care is effective in improving the quality of life for people with life-threatening illness. Palliative care needs should be better understood and accepted by all health professionals, social and welfare workers as well as the community, so that dying people have timely access to palliative care.