The Principles of Palliative Care

WHAT IS PALLIATIVE CARE?

 

The definition of palliative care has evolved over the years, as the field has developed in various countries.

 

Originally, palliative care was regarded as being applicable exclusively at the point when death was imminent.

 

In current understanding palliative care focuses on those last years or months of life when death is foreseeable rather than merely a possibility. It looks at the pattern of physical, emotional, social and spiritual suffering which may be present and which should and can be relieved.

 

In 1990 the World Health Organisation defined palliative care as:

 

“The active total care of patients whose disease is no longer 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.”

 

The term palliative derives from the Latin pallium meaning to ‘mask’ or ‘cloak’. This etymology indicates what palliative care is essentially about, that is, masking the effects of incurable disease, or providing a cloak for those who are left in the cold because they cannot be helped by curative medicine.

 

Palliative care is delivered by a multidisciplinary team and involves the use of all appropriate palliative interventions, which may include disease modifying therapies such as surgery, radiotherapy, chemotherapy etc. Individual and frequent assessments must be the basis of appropriate treatment choices.

 

A more recent WHO definition (2003) of palliative care put more emphasis on the prevention of suffering:

 

“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.”