Hospice.

Palliative medicine means caring for patients with incurable disease and short life expectancy, or, with the British definition, "the study and management of patients with active, progressive, far advanced disease, for whom the prognosis is limited and the focus of care is the quality of life". Palliative medicine is more than care for the dying. Today palliative medicine is regarded as integral to the treatment pathway for all patients with incurable disease. Up to now, mostly cancer patients have been offered specialist palliative care, but the international trend is to include other patient groups, especially patients with degenerative neurological disease and advanced cardiac and pulmonary disease. Palliative medicine is characterized by a focus not primarily on disease control but rather on symptom relief, social support, spiritual care, and maintenance of physical and psychological functioning and wellbeing. To reach these goals, a multi-professional approach is needed, and the doctor in charge must be highly qualified clinically and academically and willing and able to cooperate with colleagues and other healthcare professionals.

Hospices↗

PubMed2006

Palliative care in hospitals.

Palliative care is medical care focused on the relief of suffering and support for the best possible quality of life for patients facing serious, life-threatening illness and their families. It aims to identify and address the physical, psychological, and practical burdens of illness. Palliative care may be delivered simultaneously with all appropriate curative and life-prolonging interventions. In practice, palliative care practitioners provide assessment and treatment of pain and other symptom distress; employ communication skills with patients, families, and colleagues; support complex medical decision making and goal setting based on identifying and respecting patient wishes and goals; and promote medically informed care coordination, continuity, and practical support for patients, family caregivers, and professional colleagues across healthcare settings and through the trajectory of an illness. The field of hospital palliative care has grown rapidly in recent years in response to patient need and clinician interest in effective approaches to managing chronic life-threatening illness. The growth in the number and needs of seriously and chronically ill patients who are not clearly terminally ill has led to the development of palliative care services outside the hospice benefit provided by Medicare (and other insurers). This article reviews the clinical, educational, demographic, and financial imperatives driving this growth, describes the clinical components of palliative care and the range of service models available, defines the relation of hospital-based palliative care to hospice, summarizes the literature on palliative care outcomes, and presents practical resources for clinicians seeking knowledge and skills in the field.

Hospices↗