From the Guidelines
Palliative care is a specialized medical approach that focuses on providing relief from the symptoms, pain, and stress of serious illness, aiming to improve quality of life for both patients and their families, regardless of diagnosis or stage of disease. This approach involves a team of healthcare professionals, including doctors, nurses, social workers, chaplains, and other specialists, who work together to address physical symptoms, emotional distress, and practical needs. According to the World Health Organization's definition, as stated in the study by 1, 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, including physical, psychosocial, and spiritual issues."
Some key aspects of palliative care include:
- Providing relief from pain and other distressing symptoms
- Affirming life and regarding dying as a normal process
- Intending neither to hasten nor postpone death
- Integrating the psychological and spiritual aspects of patient care
- Offering a support system to help patients live as actively as possible until death
- Offering a support system to help the family cope during the patient's illness and with their own bereavement
Palliative care can be provided alongside curative treatments at any stage of illness, and medications commonly used include opioids like morphine or hydrocodone for pain, anti-nausea medications such as ondansetron, and anxiolytics like lorazepam for anxiety. The approach is holistic, addressing not just physical symptoms but also psychological, social, and spiritual concerns. As noted in the study by 1, palliative care teams help with advance care planning, establishing goals of care, and improving communication between patients, families, and healthcare providers. This approach is beneficial because it recognizes that serious illness affects all aspects of a person's life and that comprehensive care requires attention to the whole person, not just the disease.
In terms of specific care, palliative care teams may provide a range of services, including symptom management, emotional support, and spiritual care. For example, the study by 1 notes that palliative care can complement life-prolonging or disease-modifying therapies post-stroke and need not be reserved for those whose death is imminent. Overall, palliative care is a vital component of comprehensive care, and its integration into standard clinical management can significantly improve the quality of life for patients and their families.
From the Research
Definition of Palliative Care
Palliative care is medical care focused on the relief of suffering and support for the best possible quality of life for patients facing serious, life-threatening illness and their families 2. It aims to identify and address the physical, psychological, and practical burdens of illness.
Key Components of Palliative Care
- Assessment and treatment of pain and other symptom distress
- Employment of communication skills with patients, families, and colleagues
- Support for complex medical decision making and goal setting based on identifying and respecting patient wishes and goals
- Promotion of medically informed care coordination, continuity, and practical support for patients, family caregivers, and professional colleagues across healthcare settings and through the trajectory of an illness 2
Palliative Care Approach
Palliative care is an interdisciplinary team approach to address patients' physical, psychosocial, and spiritual needs to improve quality of life among those who have faced a life-threatening illness 3. It can be delivered simultaneously with all appropriate curative and life-prolonging interventions.
Benefits of Palliative Care
- Improvement of patient quality of life by relief of disease-related symptoms
- Support of patients and their relatives considering their current physical, psychological, social, and spiritual needs
- Increase in goals of care discussions and quality of life
- Decrease of mortality and length of stay on the ICU
- Reduction of stress reactions of relatives and ICU staff
- Higher satisfaction with therapy 4
Palliative Care in Different Settings
Palliative care can be provided in various settings, including hospitals, outpatient clinics, and intensive care units. It can be integrated into the routine daily practice by the healthcare team or provided through a consultative model 4. Hospice is a type of palliative care for patients with a prognosis of 6 months or less, focusing on avoiding hospitalization and maximizing time at home for patients who are dying 5.