Palliative derives from the Latin Pallium which means to cloak.
Palliation means to cloak over, to not address the underlying causes, but to eliminate the effects.
4 th Century Christians
1842 Jeanne Garnier Lyon France
1879 Irish Sisters of Charity Dublin
1905 St Joseph’s London
1967 St Christopher’s London
Macmillan Cancer Relief
Palliative Care Beds
% Funding for Hospices
“ Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with lifethreatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual.”
The goal of palliative care is achievement of the best possible quality of life for patients and their families
Affirms life and regards dying as a normal process
Provides relief from pain and other distressing symptoms
Integrates the psychological and spiritual aspects of patient care
Offers a support system to help patients live as actively as possible until death
To help the family cope during the patients illness and in their own bereavement
Quality of Life
Avoid the avoidable suffering
Building Capacity : empowerment to adjust, relief and support the unavoidable suffering
Comprehensiv e Care
Respect their values
Active, alive conception
Patient and relatives
We are focused on the patient and his/her family
We are Accessible
We are Collaborative
We provide high quality:
We are Safe and Effective
We are based on Evidence
We have resources
Ferris and Gómez- Batiste
Systematic therapeutic Plan.
Information and communication.
Clinical ethics as the method for decisions
Change in the micro organization: the team work
Change in the organization of resources.
Evaluation and monitoring results quality and results.
Education, training, and research
Advance Care Planning and Case management and continuity of care
General Palliative Care
Patients with less complexed needs
Nursing Homes, PC approach,
Patients with complexed needs. Multiprofessional team with specialist PC training.
Medical, Nursing, Social Work, Spiritual,
Physio, OT, Pharmacy
Provided from pre-diagnosis onwards.
Umbrella term for general & specialist services. Responsibility of all Health & Social care professionals
Vital and integral part of all clinical practice.
Informed by a knowledge of and practice of palliative care principals and supported by specialist palliative care
Quality of life
A whole person approach
Care for both the dying person and those that matter to the person
Patient autonomy and choice
It is the right of every person with a life threatening illness to receive appropriate palliative care wherever they are.
It is the responsibility of every health care professional to practice the palliative care approach, and to call in specialist palliative care colleagues if the need arises, as an integral part of good clinical practice whatever the illness or stage.
What kind of issues would effect when or why people access palliative care services?
Active – Treatments
56% wanted to die at home
25% of Cancer patients did
20% of people with other diseases did
11% wanted to die in hospital
47% of Cancer patients did
56% of people with other diseases did
24% wanted to die in a hospice.
17% of Cancer patients did
4% of people with other diseases did
National Council for Palliative Care 2003
Frequency of common symptoms in advanced illness
(Atkinson & Virdee, 2001)
Vomiting or nausea
Loss of bladder control
Loss of bowel control
Patients with cancer
Patients with progressive nonmalignant disease
VALUING connecting empowering
Making a connection
– establishing a rapport
– building up trust
Maintaining a connection
– being available, spending time, sharing secrets, sharing self, maintaining trust.
Breaking the connection
– usually as a result of the patient’s death
– recognises patient autonomy
– dealing with negative feelings
– - facilitating healing
– symptom control
– making arrangements
– acting as the patient’s advocate
Focusing on living helping the patient to live as fully as possible
– giving or reiterating bad news
– talking about death and the time left
Confronting own mortality
Feeling devalued Feeling valued
Assessment, psychosocial issues.
Be there, caring environment, promote communication
Explore previous experience, future wishes,enhance independence