Palliative care: An introduction
The World Health Organization defines palliative care as the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount. The goal of palliative care is the achievement of the best quality of life for patients and their families.1
Palliative care involves taking a holistic and multidisciplinary approach to dealing with the different problems that patients and their families may face. Good communication skills to deal with issues surrounding incurable and advanced disease are vital. Although patients with cancer have been the main recipients of palliative care, other patients, such as those with acquired immune deficiency syndrome (AIDS) and neurological disorders, for example, motor neurone disease, have also benefited from the palliative care approach.
The first hospice for the dying was established in France in 1842.2 The modern hospice movement took off in Britain in the late 1960s. This was due in part to Dame Cecily Saunders and others who endeavoured to deal with the unmet needs of the dying.
The first modern hospices were developed in the 1960s and 1970s. Outside hospices, it was clear that patients in hospitals needed better palliative care.3 This led to the setting up of hospital palliative care teams. The first such team was established in St Thomas’ Hospital in London in 1977. Today, about 340 hospitals in Great Britain and Ireland have hospital support teams or support nurses.4
The Royal College of Physicians established palliative medicine as a subspecialty of medicine in 1987 and the Calman-Hine report of 19955 stressed the importance of palliative care in cancer services. Furthermore, the NHS Cancer Plan6 identified palliative care as a priority (see Panel 1, p212).
Palliative care can also be applied to patients suffering from non-malignant disease. Indeed, the National ServiceFramework for Coronary Heart Disease emphasised the role of palliative care in endstage congestive cardiac failure.7
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Citation: Hospital Pharmacist URI: 10975246
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