Palliative care

Palliative care or hospice care is a branch of medicine that tries to improve the quality of life for patients suffering incurable, terminal illness, such as untreatable cancers, or the latter stages of AIDS.

The World Health Organisation, in a 1990 report on the topic, defined palliative care as follows:

"Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount. The goal of palliative care is the achievement of the best possible quality of life for patients and their families."

Hospice care occurs in hospitals, free-standing hospice units, and in homes. More than a place, hospice care is a philosophy. It is characterized by concern for symptom relief, general well-being, and spiritual/existential comfort for the dying. The need to maintain quality of life in dying or "quality of dying" is important as the incidence of chronic illness increases with the aging of the Western world's population.

The patient and family are the focus of hospice care, with emphasis placed upon the well-being of family caregivers as well as the patient. Opportunities for caregiver respite are one of the services hospices provide to promote caregiver well-being. Major aspects of palliative care include the relief of pain (analgesia), as well as psychological help for patients and their families to cope with the impending death.

The main difference between hospice care and palliative care is that the former is more about nursing while the latter is the physicians' term.

History

It is a relatively recent concept that originated and gained momentum in Great Britain after the founding of the first modern hospice, St. Christopher's, in 1967. Dr. Cicely Saunders is regarded as the founder of the hospice movement. Since its beginning, the hospice movement has grown dramatically.

The first hospice in the United States was established in 1974. In the U.S., hospice care is provided by a core interdisciplinary team consisting of physicians, registered nurses, chaplains, social workers, and the family. The focus of the team is to optimize symptom relief and function in people with terminal illness. Additional members of the team are likely to include home health aides, volunteers, personal care assistants, and housekeepers.