The terms 'end-of-life care' and 'palliative care' can be confusing. Patients and their families may be asked to consider these kinds of specialist care for those suffering from terminal illnesses. While the two are linked, they both have unique areas that a care specialist focuses on.
What is palliative care?
Palliative care is for people living with a terminal illness where a cure is no longer possible. It is suggested after all alternatives have been tried and is for any terminal condition. This includes terminal cancers but also complex illnesses that need their symptoms controlled. Although these people usually have an advanced, progressive condition, this isn’t always the case.
Palliative care, at its core, aims to treat or manage pain by relieving any associated physical symptoms. Treatment typically involves medicines and specialist therapy regimes but is also designed to support further needs that the specialist care team feels will help the patient. This may include physiotherapy and psychological support, with elements covering social or even spiritual needs for the patient. It includes caring for people who are nearing the end of their life. This is called end-of-life care.
The objective of palliative care is to help support the patient and everyone affected by the diagnosis (family members, friends etc) to achieve the best quality of life with the time remaining.
Palliative care objectives:
- to improve quality of the patient's life
- to improve quality of life for those affected by the patient's illness
- to offer pain relief
- to offer support for distressing symptoms associated with the illness, combining psychological, social and spiritual aspects of care
- to offer a support system to help people live as actively as possible until death
- to offer a support system to help the family cope during a person’s treatment and in bereavement
- uses a team-approach to address the needs of the person who is ill and their families - psychologists, nursing staff, care assistants, specialist care workers
Palliative care as a process has a number of aims. It looks to treat death as a natural process but with strategies in place to support life quality for as long as possible. Care givers work with the patient and the wider family by offering solutions that keep the patient as healthy for as long as possible, ideally in their own home or an environment where the patient feels most comfortable.
Palliative care does not speed up or postpone dying. It is designed to cover all aspects of coping with a terminal illness, ensuring that a support network is there at a time when people need it most. Palliative care is usually associated with the later stages of any terminal illness, but it can be offered early after diagnosis alongside other therapies in an effort to prolong the quality of a patient's life.
Palliative care can take place in hospitals or hospices but is often considered as an option in patient's own home.
What is end-of-life care?
End-of-life care is an important part of palliative care for people who are nearing the end of their life. End-of-life care is for people who are considered to be in the last year of life, although this time-frame is difficult to predict.
End-of-life care aims to help people live as well as possible and to die with dignity. It includes treatment during this time and may include complimentary services, such as help with legal matters. End-of-life care continues for as long as the patient and those affected need it.
Do specialists provide palliative care and end-of-life care?
Palliative care is a combined effort by a number of different care professionals to offer the best support to patients with a terminal condition.
Palliative care and end-of-life care are provided by two care sectors - general care and specialist care.
General care is given by those who work in the care sector and offer it as part of their day-to-day vocation. These include, community nurses and general practitioners (doctors). Social workers and spiritual care professionals also belong to this group.
These professionals constantly assess the individual patient's needs along with those of their family. The aim of general palliative care is to offer support by controlling basic levels of pain control, coordinate with other care teams in and out of hours and offer signposting to other services as required. They are the front line of support for general patient care.
What is specialist end-of-life and palliative care?
Specialist care is given by those who are experts in palliative care, such as clinical nurse specialists. This group also includes consultants in palliative medicine, clinical occupational therapists and counsellors.
Specialist palliative care services manage complex patient care problems that cannot be dealt with as part of general care. Specialists usually work in teams to offer joined-up care and patients might see one or more specialists when referred.
Specialist palliative care services may be provided by local councils (social workers etc.) and voluntary organisations. These could include, inpatient and outpatient facilities and bereavement support services for relatives of patients.
Patients will likely need support from both groups of professional through the palliative care process. Palliative care is designed to be flexible allowing teams to adapt as patient requirements change. Both are offered to patients in hospitals, hospices or care homes, as well as those that remain in their own home.