palliative care
Meaning of palliative care: The commonest misconception is that it signals giving up, when it can begin on the day of diagnosis.
Definition of palliative care
Palliative care is specialized care aimed at relieving the symptoms and the strain of a serious illness. It addresses pain, breathlessness, nausea, fatigue and the psychological, social, practical and spiritual difficulties that come with them. Its measure is quality of life, and it is provided alongside whatever treatment is directed at the disease itself.
How does it differ from hospice care?
| Palliative care | Hospice | |
|---|---|---|
| When it starts | Any point after a serious diagnosis | When life expectancy is short |
| Alongside treatment aimed at cure | Yes | No; treatment aimed at cure has been set aside |
| Stage of illness | Any | The final phase |
| Where | Clinic, hospital ward, home | Home, hospice unit, care facility |
Hospice is one form of palliative care rather than a different thing, which is the root of the confusion. All hospice care is palliative; most palliative care is not hospice. The overlapping term comfort care is used loosely for both and is worth clarifying whenever it appears in a conversation about goals.
Who provides it and what does it cover?
A team rather than an individual: physicians and nurses with additional training in symptom control, social workers, chaplains, pharmacists and therapists, working with the clinicians already treating the disease rather than replacing them. The remit is wider than pain. It takes in breathlessness, appetite loss, nausea, constipation, insomnia and fatigue, and equally the practical weight of illness, including transport, finances, work and the strain on family members. Support for carers is part of the role, and respite care is one of the practical forms it takes.
When should it begin?
There is no threshold to cross. It can begin at diagnosis and run for years alongside chemotherapy, dialysis, heart failure treatment or surgery. Trials in advanced cancer have found that introducing it early is associated with better reported quality of life and mood, and that it does not shorten survival. The persistent belief that accepting it means abandoning treatment is the main reason it is requested later than it might be, and the name itself contributes, since the word suggests an ending to many people who encounter it for the first time.
Also known as
Used in a sentence
The palliative care team was consulted to help manage the patient's pain and other symptoms during treatment.
Good to know
Palliative care can be provided at any stage of a serious illness and alongside treatment aimed at cure, which distinguishes it from hospice care, a form of palliative care reserved for people no longer pursuing curative treatment.
Word origin
Where “palliative care” comes from
From Latin pallium, meaning cloak, reflecting the original sense of palliative treatment as one that cloaks or eases symptoms rather than removing their underlying cause.