Palliative care aims to enhance the quality of life for patients – and their loved ones – when they face a life-threatening illness or approach the end of life.
WHAT IS PALLIATIVE CARE?
Palliative care aims to enhance the quality of life for patients – and their loved ones – when they face a life-threatening illness or approach the end of life.
WHAT IS PALLIATIVE CARE?
Palliative care aims to enhance the quality of life for patients – and their loved ones – when they face a life-threatening illness or approach the end of life.
WHAT IS PALLIATIVE CARE?
The core principle of palliative care is to provide holistic care that addresses four areas of need: physical, psychological, social and spiritual. These can be seen as four dimensions which constitute a person’s ‘total pain’. The treatment of physical pain is often the most urgent aspect of palliative care, but the needs of each patient and the people who care for them will be different.
Physical
Undesirable effects of treatment
Insomnia and chronic fatigue
Other symptoms
Insomnia and chronic fatigue
Other symptoms
Psychological
Anger at delays in diagnosis
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Spiritual
Why has this happened to me?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Social
Worry about family and finances
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Total pain
Twycross R, Wilcock A and Stark Toller C. (2021) Introducing palliative care (6th ed).
Psychological
Anger at delays in diagnosis
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Spiritual
Why has this happened to me?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Social
Worry about family and finances
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Social
Worry about family and finances
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Why has this happened to me?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Spirital
Anger at delays in diagnosis
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Psychological
Psychological
Anger at delays in diagnosis
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Psychological
Anger at delays in diagnosis
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Anger at therapeutic failure
Disfigurement
Fear of pain and/or death
Feelings of helplessness
Social
Worry about family and finances
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Spiritual
Why has this happened to me?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Physical
Undesirable effects of treatment
Insomnia and chronic fatigue
Other symptoms
Insomnia and chronic fatigue
Other symptoms
Social
Worry about family and finances
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Loss of job prestige and income
Loss of social position
Loss of role in family
Feelings of abandonment and isolation
Total pain
Twycross R, Wilcock A and Stark Toller C. (2021) Introducing palliative care (6th ed).
Spirital
Why has this happened to me?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
Why does God allow me to suffer like this?
What's the point of it?
Is there any meaning of purpose in life?
Can I be forgiven for past wrongdoing?
There is no fixed time in an illness when someone should begin receiving palliative care, although it is often most urgent when someone is approaching death. This is commonly the case with cancer, where doctors can tell by changes in a patient’s condition that they are in the last days or weeks of life. Plans can then be put in place to help reduce the pain, distress or any other concerns of the patient and their loved ones.
Palliative care can also help people with life-threatening illnesses while they still have months or maybe years to live. Even at this earlier stage of illness, the patient or their family might need either short-term help or ongoing support. It is important to understand that palliative care can be given alongside treatment aiming to cure or help control the disease – it not a choice of one type of care or the other.
There is no fixed time in an illness when someone should begin receiving palliative care, although it is often most urgent when someone is approaching death. This is commonly the case with cancer, where doctors can tell by changes in a patient’s condition that they are in the last days or weeks of life. Plans can then be put in place to help reduce the pain, distress or any other concerns of the patient and their loved ones.
Palliative care can also help people with life-threatening illnesses while they still have months or maybe years to live. Even at this earlier stage of illness, the patient or their family might need either short-term help or ongoing support. It is important to understand that palliative care can be given alongside treatment aiming to cure or help control the disease – it not a choice of one type of care or the other.
Diagnosis
Death
Disease-modifying therapy
Palliative care
Bereavement
support
support
Palliative care is provided by different health and care staff working together in a single multi-professional team. They include doctors, nurses, psychologists, social workers, chaplains, physiotherapists, occupational therapists and, for child patients, paediatric specialists. This team-based approach reflects the ‘holistic’ nature of palliative care.
Good quality palliative care begins with an assessment of the patient and their family’s situation and needs. The palliative care team then works together to put in place a care plan which can be delivered as needed by different members of the team.
Good quality palliative care begins with an assessment of the patient and their family’s situation and needs. The palliative care team then works together to put in place a care plan which can be delivered as needed by different members of the team.
WHO PROVIDES PALLIATIVE CARE?
Palliative care is provided by different health and care staff working together in a single multi-professional team. They include doctors, nurses, psychologists, social workers, chaplains, physiotherapists, occupational therapists and, for child patients, paediatric specialists. This team-based approach reflects the ‘holistic’ nature of palliative care.
Good quality palliative care begins with an assessment of the patient and their family’s situation and needs. The palliative care team then works together to put in place a care plan which can be delivered as needed by different members of the team.
Good quality palliative care begins with an assessment of the patient and their family’s situation and needs. The palliative care team then works together to put in place a care plan which can be delivered as needed by different members of the team.
WHO PROVIDES
PALLIATIVE CARE?
PALLIATIVE CARE?
WHO PROVIDES PALLIATIVE CARE?
Key principles of palliative care:
- affirms life but regards dying as a normal process
- neither hastens nor postpones death
- provides relief from pain and other distressing symptoms
- integrates the psychological and spiritual aspects of care
- offers a support system to help patients live as actively as possible until death
- offers a support system to help patients' families cope during the patient's illness and in bereavement.
Palliative care is today recognised by the World Health Organization and the United Nations as an integral part of universal health coverage. This means all people should have access to palliative care, when and where they need it, without financial hardship. The challenge for PACED and other organisations committed to palliative care is to turn that right into reality.
UNIVERSAL HEALTH COVERAGE
Palliative care is today recognised by the World Health Organization and the United Nations as an integral part of universal health coverage. This means all people should have access to palliative care, when and where they need it, without financial hardship. The challenge for PACED and other organisations committed to palliative care is to turn that right into reality.
UNIVERSAL HEALTH COVERAGE
promotion
treatment
prevention
rehabilitation
palliative care
Caring for children is a specialty in its own right. Just as paediatric doctors look after medical conditions affecting infants, children and young people, so paediatric palliative care clinicians help children who are dying or have life-limiting illnesses. Children’s organs are still developing and their bodies respond differently from adults to medicines and other forms of treatment, so this is a highly specialised area of palliative care.
Home care
The patient’s wishes should inform where they receive treatment and where they are supported as they approach death. In most countries and cultures, people want to remain at home, in familiar surroundings and among their loved ones. At these times, a package of home-based care is put in place that is delivered by multi-professional team and which also guides and supports the family to help care for their relative.
In-patient care
There are situations when a hospital or hospice is more appropriate. This might be for social reasons, for example if there is no family able to provide home-based care. It might also be for clinical reasons, particularly where specialist treatment is required. Cancer, for example, can cause intense pain which worsens close to death and strong opioids such as morphine might need to be given under close medical supervision.
The past and the present of palliative care
In countries with well-developed healthcare systems, most people live near a hospice, where staff have expertise in providing holistic care across all four dimensions of need. Hospices have increased in number since the 1960s when Dame Cicely Saunders led the birth of the modern hospice movement at St Christopher’s Hospice in London. In many countries specialist palliative care units are also found in hospitals, sometimes as part of a cancer unit. However, in Eastern Europe and Central Asia, most people do not have access to specialist palliative care in any setting. That is why PACED works to educate family doctors so they can provide good quality palliative care.
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