Palliative care is available to acutely ill patients, may be provided along with disease-specific, life-prolonging treatment. Meticulous attention to be prevention and relief of pain and other burdensome symptoms is a basic part of quality palliative care. Yet, comprehensive palliative care includes much more. Psychosocial and spiritual care, counseling, and guidance in choosing among treatment options, and assisting with practical support for patients and caregivers are all equally fundamental components of comprehensive palliative care. It is critical to stress that palliative care should be provided from the time of diagnosis of a serious, debilitating, or life-limiting illness. Palliative care should be an integral part of healthcare aimed to achieve best possible outcomes including optimal quality of life, function, and opportunities for personal growth across the life span. Palliative care can and should be provided along with any disease-modifying treatments. And, yes, for some people with advanced illness, palliative care may be the main focus of care.
寧養服務適用於任何人——無論什麼年齡, 種族, 文化, 背景或宗教, 而且大多數服務是免費的。您可以在病情的任何階段使用寧養服務，這並不僅僅是為生命即將到達終點的人而設。使用寧養服務並不意味著生命沒有希望，您已經“放棄”或您的家庭不在乎您。您可以在接受寧養服務的同時繼續治療。
Palliative care enhances the care of patient and families in many ways. Key aspects include:
- Expert management of pain and other symptoms such as shortness of breath, fatigue, constipation, anxiety, and depression can greatly enhance quality of life for patients and their caregivers.
- (With better symptom management, function often improves and there is growing evidence that palliative care improves quality of life and may lead to longer survival.)
- Advance care planning, discussions of treatment goals that align with patient’s values and preferences, intensive communication with the patient and family, and assistance with coordination of care.
- (Palliative care can help by assisting in coordination of care across settings such as home, hospital, or nursing facility.
- (Palliative care clinicians work with patients, caregivers, and other healthcare professionals to assist patients and caregivers in understanding their medical condition and treatment options
- (Palliative care looks at the whole patient with consideration for their physical, emotional, social, and spiritual needs.
- Palliative care teams vary by setting, but are typically interdiscplinary and other include a physician, a nurse, a social worker, and a chaplain.
• 醫務人員和其他護理服務機構人員的定期探訪, 可能包括: 醫生和護士, 社工, 宗教或心灵导师
A well-functioning palliative care team is essentially comprised of a physician, advanced practice or registered nurse, a master’s level social worker, and a chaplain. Each member of the team has been certified to pratice in the field of palliative care. Team members value disciplines to meet the goal of exceptional patient and family care.
The WHO defines palliative care as:
Palliative is an approach that improves the quality of life of patients and their families facing the problem 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.
– Provides relief from pain and other distressing symptoms;
– Affirms life and regards dying as a normal process;
– Intends neither to hasten or 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 counseling, 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.
All hospice care is palliative care, but not all palliative care is hospice care. Both share the same goal of providing family-centered, whole-person care that relieves suffering, enhances quality of life, and is individualized to each patient’s values, beliefs, and culture. Although palliative care may and should be offered to patients based on needs, independent of prognosis or diagnosis, only patients with a certified prognosis of less than six months are eligible for hospice.
Examples of patients who may be appropriate for palliative care rather than hospice care:
- Those on experimental protocols and/or who are receiving palliative chemotherapy, immunitherapy, and/or radiation therapy.
- Individuals who are terminally ill and need assistance clarifying goals of care.
- Patients who are still receiving active treatment for their incurable illness but who can also benefit from support services and symptom management.
- Children with severe congenital anomalies who will die quickly and often will remain in the hospital or those with a serious or life-threatening illness, but are considered to be far from the terminal stage.
- Patients who have sustained an injury or a complication from treatment where recovery is unlikely.
Issues that affect palliative care utilization include:
- Patient, families, and staff may have difficulty transitioning from curative to palliative care
- Most programs are located in hospital-based, hierarchical medical institution
- Some programs may not provide continuity and communication with primary care physicians and community-based programs
- Some programs may not provide supportive services such as social work, spiritual, volunteer, or bereavement follow-up, as compared to hospice care.