Palliative care

Summary

Definition: palliative care is defined as the active care of patients with active, progressive or advanced disease, often with a limited prognosis for whom control of pain, other symptoms, psychological, social and spiritual issues are paramount. The goal of palliative care is achievement of the best quality of life for patients and their families.

Principles of palliative care: main principles are to provide holistic, integrated care to patients and families. (1) Provide relief of pain and other symptoms. (2) Integrate the psychological and spiritual care. (3) Provide support to help patients live as actively as possible until death. (4) Help patient's families cope during the patient's illness and in their own bereavement. (5) Any patient may be referred with any diagnosis at any stage of disease.

Palliative care services in UK: there are four core service structures providing palliative care, including hospital support teams, community palliative care teams, specialist day care units, and specialist inpatient care mainly provided by hospices. Patients with any diagnosis may be referred to a specialist palliative care service at any stage of their illness. Referrals should be based on need not prognosis. Many national and local charities (for example Macmillan Cancer Relief, and Marie Curie) are the main providers of specialist palliative care services. A directory of services can be obtained from www.hospiceinformation.info.

Management of common symptoms

Pain: pain is experienced by the majority of patients, and is a major cause of morbidity, isolation and fear. Assessment and review of a patient's pain is important in achieving good pain control.