Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "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, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.
Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of the elderly. The term geriatrics originates from the Greek γέρων geron meaning "old man", and ιατρός iatros meaning "healer". It aims to promote health by preventing, diagnosing and treating disease in older adults. There is no defined age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of older people. Rather, this decision is guided by individual patient need and the caregiving structures available to them. This care may benefit those who are managing multiple chronic conditions or experiencing significant age-related complications that threaten quality of daily life. Geriatric care may be indicated if caregiving responsibilities become increasingly stressful or medically complex for family and caregivers to manage independently.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.
End-of-life care (EOLC) is health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.
The Liverpool Care Pathway for the Dying Patient (LCP) was a care pathway in the United Kingdom covering palliative care options for patients in the final days or hours of life. It was developed to help doctors and nurses provide quality end-of-life care, to transfer quality end-of-life care from the hospice to hospital setting. The LCP is no longer in routine use after public concerns regarding its nature. Alternative methodologies for Advance care planning are now in place to ensure patients are able to have dignity in their final hours of life. Hospitals were also provided cash incentives to achieve targets for the number of patients placed on the LCP.
Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. Shortages of qualified nurses are found in many countries.
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering. Hospice care provides an alternative to therapies focused on life-prolonging measures that may be arduous, likely to cause more symptoms, or are not aligned with a person's goals.
Advance care planning is a process that enables individuals with decisional mental capacity to make plans about their future health care. Advance care plans provide direction to healthcare professionals when a person is not in a position to make and/or communicate their own healthcare choices. Advance care planning is applicable to adults at all stages of life. Participation in advance care planning has been shown to reduce stress and anxiety for patients and their families, and lead to improvements in end of life care. Older adults are more directly concerned as they may experience a situation where advance care planning can be useful. However, a minority use them. A research conducted in Switzerland with people aged 71 to 80 showed that better knowledge on advance care planning dispositions could improve the perception older people have of them. Communication on dispositions should take into account individual knowledge levels and address commonly enunciated barriers that seem to diminish with increased knowledge.
Ann Patricia Bowling is a British and Irish sociologist and academic, specializing in research on ageing, quality of life, and research methods. Bowling developed the internationally recognized Older People's Quality of Life questionnaire (OPQOL). Bowling was most recently Professor of Health Sciences, University of Southampton (2012–17), where she is now visiting professor.
Caryl Merryn Gott is a New Zealand social science academic specialising in palliative care. She is currently a full professor at the University of Auckland.
The 4 'A's Test (4AT) is a bedside medical scale used to help determine if a person has positive signs for delirium. The 4AT also includes cognitive test items, making it suitable also for use as a rapid test for cognitive impairment.
Mhoira E.H. LengFRSE MBChB MRCP(UK) FRCP(Ed and Glas) is one of the first Scottish specialists in palliative care, who has developed the palliative care services internationally, working in Eastern Europe, India and Africa and advises international institutions and agencies on palliative care in the developing world. In 2021, Leng was admitted as one of the new female Fellows of the Royal Society of Edinburgh.
Catherine "Kit" Ann Chesla is an American nurse who is Professor Emeritus and former Thelma Shobe Endowed Chair at the University of California, San Francisco School of Nursing. Her research has considered families and chronic illness.
Sonja Jayne McIlfatrick is a nurse and Professor in Nursing and Palliative Care and Dean of Ulster Doctoral College at Ulster University. She was the first non-American President of the International Network of Doctoral Education in Nursing.
Joanne Rycroft-Malone is a British researcher who is a Distinguished Professor and the Executive Dean of the Faculty of Health and Medicine at Lancaster University. She is Programme Director and Chair of the Health and Social Care Delivery Research programme.
Karen Jean Hoare is a New Zealand professor at Massey University, and is New Zealand's first active nurse practitioner to also be a professor. Her research focuses on models for care for children and young people.
Ageing Well was one of New Zealand's eleven collaborative research programmes known as National Science Challenges. Running from 2015 to 2024, the focus of Ageing Well National Science Challenge (AWNSC) research was sustaining health and wellbeing towards the end of life, particularly in Māori and Pacific populations in New Zealand.
Ofanaite Ana Dewes is a New Zealand academic, and an Associate Investigator at the Maurice Wilkins Centre and a Research Fellow at the University of Auckland, New Zealand.
Lynn Carol McBain is a Canadian–New Zealand academic and specialised general practitioner, and is a full professor at the University of Otago, specialising in research on medical education, and primary health services. She is a Distinguished Fellow of the Royal New Zealand College of General Practitioners.
Jean Ross is a Welsh–New Zealand registered nurse, author and academic, and is a full professor at the Otago Polytechnic, specialising in rural nursing, nurse education and rural health. She has worked in rural nursing for more than thirty years, and in 2008 she won the Peter Snow Memorial Award for her contribution to rural health care.
