Hospice And Palliative Care

Hospice And Palliative Care

Terminology

Hospice care and palliative care are similar, but distinct, terms sharing the common belief that, “the relief of suffering is a long standing, central, and fully legitimate aim of medicine.” End-of-life care refers to both hospice care and palliative care. The basic principle of end-of-life care is to optimize the quality of life for the patient and family in the last weeks and months of life, as well as to provide support beyond the end of life into bereavement.

Palliative care, which includes hospice care, is ideally introduced early in the disease progression to provide support to patients with a serious chronic or life-threatening illness. The word “palliation,” derived from the Latin word “pallium” (a cloak), has been defined as “treatment to reduce the violence of a disease.”¹ The World Health Organization defines palliative care as an approach that improves the quality of life of patients and their families who are facing a life-threatening illness, by preventing and relieving suffering through early identification and impeccable assessment and treatment of pain and other physical, psychosocial, and spiritual problems.² Palliative care

• Affirms life and regards dying as a normal process
• Provides relief from pain and other distressing symptoms
• Intends neither to hasten nor postpone death
• Integrates the psychological and spiritual aspects of patient care
• Offers a support system to help patients live as actively as possible until death
• Uses a team approach to address the needs of the patient and his or her family during the patient's illness and to provide bereavement counseling when indicated³

The provision of palliative care by interdependent health team members composed of physicians, nurses, pharmacists, social workers, and others has been successful in meeting the unique needs of patients with difficult or terminal illnesses.^{4,5,6,7,8,9,10}

Hospice, originally a place or way station for people making a pilgrimage, is considered both a philosophy of care and a place to deliver care. Hospice care can be delivered in a building designated as a hospice, in the patient's home, or in a facility where the patient resides. As a programmatic model for delivering palliative care, hospice care provides a team approach to the individualized symptom management (e.g., pain), as well as psychosocial, emotional, and spiritual support for the patient and his or her family and caregivers during the last months of life.¹¹

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