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What is palliative care?

Sometimes our field is described as “palliative care” but depending on what people understand by this term, this language can cause confusion.

Though more specific definitions can be helpful, one way of thinking about “palliative care” is to talk in terms of providing ‘good care’ to people whose health is in irreversible decline or whose lives are coming to an inevitable close. Perhaps what differentiates ‘palliative care’ from ‘just good care’ is the awareness that a person’s mortality has started to influence clinical and/or personal decision-making.

However, palliative care is not synonymous with death – it is about life, about the care of someone who is alive, someone who still has hours, days, months, or years remaining in their life, and about optimising wellbeing in those circumstances.

Therefore, in Scotland, much of the care that people receive when their health is deteriorating could be termed generalist palliative care, being provided by health and social care staff to people living in the community, in care homes and in hospitals. It is palliative care regardless of whether someone has cancer, organ failure (including neurological conditions) or ‘old age’, or whether they are living at home, in a hospice, in a care home or in a medical ward, ICU or neonatal ward. Palliative care can and should be delivered alongside active treatment where that is appropriate.

Specialist palliative care can help people with more complex palliative care needs and is provided by specially trained multi-professional specialist palliative care teams who are generally based in a hospice, an NHS specialist palliative care unit or an acute hospital, but whose expertise should be accessible from any care setting and at any time.

Palliative care includes, but is not exclusively about, end of life care. End of life care is that part of palliative care which should follow from the diagnosis of a patient entering the process of dying, whether or not he or she is already in receipt of palliative care. This phase could vary between months, weeks, days or hours in the context of different disease trajectories. There can be uncertainty involved in identifying when someone might be expected to die – illness can be unpredictable, and changes can occur suddenly and unexpectedly.

The World Health Organization definition of palliative care can be viewed here: World Health Organization definition of palliative care:

More specific information about palliative care, designed for individuals, families and carers is available here: NHS Inform website.

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