DEFINITIONS of Palliative Care

Palliative care is the care of patients with active, progressive, far-advanced disease, for whom the focus of care is the relief and prevention of suffering and the quality of life.
The following should be noted

→ active disease: this activity can be confirmed and measured objectively by clinical examination and investigations
→ progressive disease: this too can be assessed clinically
→ far-advanced disease: more difficult to define but examples are
o extensive metastatic disease in cancer
o refractory cardiac failure
o total dependency in neurodegenerative conditions or Alzheimer’s disease
→ focus on the quality of life is the key feature of the definition
→ it is person-oriented, not disease-oriented
→ it is not primarily concerned with life prolongation (nor with life shortening)
→ it is not primarily concerned with producing long term disease remission
→ it is holistic in approach and aims to address all the patient’s problems, both physical and psychosocial
→ it uses a multidisciplinary or interprofessional approach involving doctors, nurses and allied health personnel to cover all aspects of care
→ it is dedicated to the quality of whatever life remains for the patient
→ palliative care is appropriate for all patients with active, progressive, faradvanced disease and not just patients with cancer
→ palliative care is appropriate for patients receiving continuing therapy for their underlying disease
→ palliative care should never be withheld until such time that all treatment alternatives for the underlying disease have been exhausted

The message of palliative care is that whatever the disease, however advanced it is, whatever treatments have already been given, there is always something which can be done to improve the quality of the life remaining to the patient.

WORLD HEALTH ORGANIZATION DEFINITION

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 nor 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 patient’s 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

http://www.who.int/cancer/palliative/definition/en/

Source:
The IAHPC Manual of Palliative Care 3rd Edition
https://hospicecare.com/what-we-do/publications/manual-of-palliative-care/

Palliative Care Definition - International Association for Hospice & Palliative Care

Palliative Care Definition

Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness, and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers.

Palliative care:

Includes, prevention, early identification, comprehensive assessment and management of physical issues, including pain and other distressing symptoms, psychological distress, spiritual distress and social needs. Whenever possible, these interventions must be evidence based.
Provides support to help patients live as fully as possible until death by facilitating effective communication, helping them and their families determine goals of care.
Is applicable throughout the course of an illness, according to the patient’s needs.
Is provided in conjunction with disease modifying therapies whenever needed.
May positively influence the course of illness.
Intends neither to hasten nor postpone death, affirms life, and recognizes dying as a natural process.
Provides support to the family and the caregivers during the patient’s illness, and in their own bereavement.
Is delivered recognizing and respecting the cultural values and beliefs of the patient and the family.
Is applicable throughout all health care settings (place of residence and institutions) and in all levels (primary to tertiary).
Can be provided by professionals with basic palliative care training.
Requires specialist palliative care with a multiprofessional team for referral of complex cases.

To achieve palliative care integration, governments should:

Adopt adequate policies and norms that include palliative care in health laws, national health programs and national health budgets;
Ensure that insurance plans integrate palliative care as a component of programs;
Ensure access to essential medicines and technologies for pain relief and palliative care, including pediatric formulations;
Ensure that palliative care is part of all health services (from community health-based programs to hospitals), that everyone is assessed, and that all staff can provide basic palliative care with specialist teams available for referral and consultation;
Ensure access to adequate palliative care for vulnerable groups, including children and older persons;
Engage with universities, academia and teaching hospitals to include palliative care research as well as palliative care training as an integral component of ongoing education, including basic, intermediate, specialist, and continuing education.

To see the glossary of terms, click here.

i Suffering is health-related when it is associated with illness or injury of any kind. Health related suffering is serious when it cannot be relieved without professional intervention and when it compromises physical, social, spiritual and/or emotional functioning. Available in http://pallipedia.org/serious-health-related-suffering-shs/

ii Severe illness is any acute or chronic illness and/or health condition that carries a high risk of mortality, negatively impacts quality of life and daily function, and/or is burdensome in symptoms, treatments, or caregiver stress. Available at https://pallipedia.org/severe-illness/

Source:
https://hospicecare.com/what-we-do/projects/consensus-based-definition-of-palliative-care/definition/