Definition of palliative care and end-of-life

Palliative care is specialist care provided for all people living with, and dying from an eventually fatal condition and for whom the primary goal is quality of life.^[1]

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care:

• provides relief from pain and other distressing symptoms;
• affirms life and regards dying as a normal process;
• intends neither to hasten nor postpone death;
• integrates the psychological and spiritual aspects of patient care;
• offers a support system to help patients live as actively as possible until death;
• offers a support system to help the family cope during the patient’s illness and in their own bereavement;
• uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
• will enhance quality of life, and may also positively influence the course of illness;
• is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

That part of life where a person is living with, and impaired by, an eventually fatal condition, even if the prognosis is ambiguous or unknown. Death is likely within a matter of days and no acute intervention is planned or required.

End-of-life care combines the broad set of health and community services that care for the population at the end of their life. Quality end-of-life care is realised when strong networks exist between specialist palliative care providers, primary generalist providers, primary specialists and support care providers and the community – working together to meet the needs of people requiring care.

Needs-based end-of-life care is a quality management approach that evaluates the individual holistic needs of the patients and their families and carers and coordinates appropriate care. The end-of-life needs of many patients are appropriately met by primary care (generalist, and other specialist and support care) providers with specialist palliative care providers contributing direct, indirect care or consultation advice as required.

This approach recognises that patients with more complex needs may require periodic or ongoing direct care from specialist palliative care providers.