Is Palliative Care the same as Hospice Care?
Yes, the principles are the same.
- → hospice means different things in different countries—it is variously used to refer to a philosophy of care, to the buildings where it is practised, to care offered by unpaid volunteers, or to care in the final days of life
- → it is better to adopt and use the term palliative care
Should a Palliative Care service provide care for patients with chronic diseases?
No, although their care is important.
- → patients with chronic conditions such as rheumatoid arthritis, degenerative diseases, diabetes mellitus and similar conditions usually do not have active, progressive, far-advanced disease
- → nevertheless, many of the principles of palliative care are appropriate to the management of patients with chronic diseases
Should a Palliative Care service provide care for patients with incurable diseases?
No, although their care is important.
- → as with patients with chronic diseases, these patients usually do not have active, progressive, far-advanced disease
- → nevertheless, many of the principles of palliative care are appropriate to the management of patients with incurable diseases
Should a Palliative Care service provide care for patients incapacitated by their disease?
No, although their care is important.
- → patients incapacitated by psychiatric illness, cerebrovascular accidents, trauma, dementia and the like deserve special care but they usually do not have active, progressive, far-advanced disease
- → nevertheless, many of the principles of palliative care are appropriate to the management of patients incapacitated by their disease
Should a Palliative Care service provide care for the elderly?
No, although their care is important.
- → many patients needing palliative care are elderly but they need palliative care because of the underlying disease from which they are suffering, not because of their age
- → nevertheless, many of the principles of palliative care are appropriate to the management of the elderly
Is Palliative Care just Terminal Care or Care of the Dying?
No.
- → the provision of high quality care during the final days and hours of life is an important part of palliative care
- → palliative care should be initiated when the patient becomes symptomatic of their active, progressive, far-advanced disease and should never be withheld until such time as all treatment alternatives for the underlying disease have been exhausted
Should Palliative Care stay separate from mainstream medicine?
No.
- → palliative care originated because of the belief that terminally ill patients were not receiving optimal care and there was for a long time mutual distrust between the practitioners of palliative care and orthodox medicine
- → modern palliative care should be integrated into mainstream medicine
- → it provides active and holistic care that is complementary to the active treatment of the underlying disease
- → it will foster palliative care skills for other health care professionals, particularly better pain and symptom control and appreciation of the psychosocial aspects of care
Is Palliative Care not just "old-fashioned" care?
No.
- → palliative care was originally separate from mainstream medicine, and was frequently practised by very caring individuals who knew little about medicine
- → modern palliative care is more integrated with other health care systems and calls for highly trained doctors and nurses, competent in a range of medical disciplines including internal medicine, pharmacology, communications skills, oncology and psychotherapy
Is Palliative Care what you do when "nothing more can be done"?
No.
- → no patient should ever be told "there is nothing more that can be done"—it is never true and may be seen as abandonment of care
- → it may be permissible to say there is no treatment available to stop the progression of the underlying disease, but it is always possible to provide care and good symptom control
Does Palliative Care include euthanasia and physician-assisted suicide?
No.
- → a request for euthanasia or assisted suicide is usually a plea for better care
- → depression and psychosocial problems are frequent in patients making requests
- → unrelieved or intolerable physical or psychosocial suffering should be infrequent if patients have access to modern interprofessional palliative care
- → terminally ill patients suffering intractable symptoms can be treated by sedation; this does not constitute euthanasia or physician-assisted suicide
Is a Palliative Care service really a pain service and its doctors pain specialists?
No.
- → Most but not all patients needing palliative care have pain of one sort of another but there are usually many other reasons for their distress. Focusing on pain to the exclusion of the others does not help the patient.
- → Palliative medicine doctors have all had advanced training in pain management but not necessarily in invasive measures (though these are less frequently used in modern palliative care.). Their training has embraced all aspects of suffering – physical, psychosocial and spiritual –but their certification is in palliative medicine, not chronic pain management.
Source:
The IAHPC Manual of Palliative Care 3rd Edition
https://hospicecare.com/what-we-do/publications/manual-of-palliative-care/
