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 and other problems, physical, psychosocial, and spiritual." In the past, palliative care was a disease specific approach, but today the WHO takes a broader approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness.
Thanatology is the scientific study of death and the losses brought about as a result. It investigates the mechanisms and forensic aspects of death, such as bodily changes that accompany death and the postmortem period, as well as wider psychological and social aspects related to death. It is primarily an interdisciplinary study offered as a course of study at numerous colleges and universities.
In medicine, specifically in end-of-life care, palliative sedation is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route.
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.
Ira Robert Byock is an American physician, author, and advocate for palliative care. He is founder and chief medical officer of the Providence St. Joseph Health Institute for Human Caring in Torrance, California, and holds appointments as active emeritus professor of medicine and professor of community health and family medicine at the Geisel School of Medicine at Dartmouth College. He was director of palliative medicine at Dartmouth–Hitchcock Medical Center, from 2003–14, and associate director for patient and family-centered care at the affiliated Norris-Cotton Cancer Center.
End-of-life care refers to 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 pathways 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.
The Journal of Pain and Symptom Management is a monthly peer-reviewed medical journal that was established in 1986. It is a continuation of the PRN Forum, a bimonthly journal published from 1982 to 1985. It is the official journal of the American Academy of Hospice and Palliative Medicine and the National Hospice and Palliative Care Organization. It was formally the official journal of the United States Cancer Pain Relief Committee. The journal covers clinical research related to "the relief of illness burden among patients afflicted with serious or life-threatening illness".
The American Academy of Hospice and Palliative Medicine (AAHPM) is a professional organization for physicians specializing in Hospice and Palliative Medicine, headquartered in Chicago, Illinois. Membership is open to all health care providers committed to improving the care of patients with serious or life-threatening illnesses. AAHPM has more than 5,200 members; 82 percent are physicians, 12 percent are nurses or other health care providers and 6 percent are residents or students.
In the United States, hospice care is a type and philosophy of end-of-life care which focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. The concept of hospice as a place to treat the incurably ill has been evolving since the 11th century. Hospice care was introduced to the United States in the 1970s in response to the work of Cicely Saunders in the United Kingdom. This part of health care has expanded as people face a variety of issues with terminal illness. In the United States, it is distinguished by extensive use of volunteers and a greater emphasis on the patient's psychological needs in coming to terms with dying.
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.
Diane E. Meier, an American geriatrician and palliative care specialist. In 1999, Dr. Meier founded the Center to Advance Palliative Care, a national organization devoted to increasing access to quality health care in the United States for people living with serious illness. She continues to serve as CAPC's Director Emerita and Strategic Medical Advisor. Meier is also Vice-Chair for Public Policy, Professor of Geriatrics and Palliative Medicine and Catherine Gaisman Professor of Medical Ethics at the Icahn School of Medicine at Mount Sinai Hospital in New York City. Meier was founder and Director of the Hertzberg Palliative Care Institute at the Icahn School of Medicine in New York City from 1997 to 2011.
Robert Twycross is a retired British physician and writer. He was a pioneer of the hospice movement during the 1970s, when he helped palliative care gain recognition as an accepted field of modern medicine.
In 2006, hospice and palliative medicine was officially recognized by the American Board of Medical Specialties, and is co-sponsored by the American Boards of
Children’s Hospices Across Scotland (CHAS), formally known as Children's Hospice Association Scotland, is a registered charity that provides the country's only hospice services for children and young people with life-shortening conditions. The first hospice was built thanks to the late editor-in chief of the Daily Record and Sunday Mail, Endell Laird, who launched a reader appeal which raised £4million. CHAS offers children’s hospice services, free of charge, to every child, young person and their families who needs and wants them. CHAS was formed in February 1992 by a group of professionals and parents of children with life-shortening conditions who had travelled to England for hospice care. In 2018/19, CHAS supported 465 children with a life-shortening condition, and their siblings, parents and wider families. The care provided is multi-disciplinary, including from doctors, nurses, social workers, pharmacists, play specialists and others. CHAS also employs medical and nursing staff who work in hospitals alongside NHS doctors and nurses.
Anne Merriman, MBE, MCommH, FRCPI, FRCP is a British doctor, known for her pioneering work and influential research into palliative care in developing countries in Africa. She has campaigned to make affordable oral morphine widely available.
M. R. Rajagopal is an Indian palliative care physician referred to as the 'father of palliative care in India' in honour of his significant contribution to the palliative care scene in India.
Luis Jose De Souza is an Indian surgical oncologist and the founder of Shanti Avedna Ashram, a charitable trust which runs a network of hospices in Mumbai and Goa. He has also contributed to the establishment of Indian Cancer Cell, an educational program co-sponsored by Tata Memorial Centre, Union for International Cancer Control (UICC) and Indian Cancer Society, for creating cancer awareness in schools. The Government of India awarded him the fourth-highest civilian honour of the Padma Shri in 1992.
Harvey Max Chochinov is a Canadian academic and psychiatrist from Winnipeg, Canada. He is a leading authority on the emotional dimensions of end-of-life, and on supportive and palliative care. He is a Distinguished Professor of Psychiatry at the University of Manitoba and a Senior Scientist at CancerCare Manitoba Research Institute.
Stephen Robert Connor is an American licensed clinical health psychologist, researcher, author, executive and palliative care consultant. He is the executive director of the Worldwide Hospice Palliative Care Alliance (WHPCA), formerly called the Worldwide Palliative Care Alliance (WPCA). From 1998 to 2008 he served as Vice President of Research and Development at the National Hospice and Palliative Care Organization (NHPCO). He has promoted global initiatives for hospice and end-of-life care programs through the World Health Assembly. He has also addressed the UN General Assembly on the need for greater pain management in palliative care.
