Many Names, Same Focus of Care
Historically, the terms hospice and palliative care have evolved to have meanings that
vary from place to place for patients, families and healthcare providers. At present there
is no consensus as to the single word that should be used to generically describe the approach
to care that aims to relieve suffering and improve quality of living and dying through approaches
different from those intended to modify disease. Consequently, clinical services with a similar focus of caring have developed different
names, thus creating confusion. Some of these names listed in alphabetical order include:
- Advanced care
- Butterfly care
- Cancer rehabilitation
- Comfort care
- Comprehensive care
- End-of-life care
- Hospice care
- Palliative care
- Rainbow care
- Supportive care
- Terminal care
There is an evolving consensus as to the issues involved, and the "best practices" to
the interventions that constitute "best practices" to manage care for each patient who
requires these services.
While it is important for healthcare providers to share a common language to facilitate
communication and share ideas, clinicians and administrators should focus on the skills
and resources needed to provide patients and families the most effective relief of suffering
and improvement of quality of life. They should not be distracted or delayed by the choice
of a name. Use a name that works in the local setting.
Whatever the name, an institution will want to choose the
elements for its program
so that it can meet the expectations and needs of its patients and families.
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CAPCManual Attribution:
von Gunten CF,
Ferris FD,
Portenoy RK,
Glajchen M, eds.
CAPCManual: How to Establish A Palliative Care Program.
New York, NY: Center to Advance Palliative Care, 2001.
©
Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, CA
and
The Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY, 2001
Permission to reproduce for non-commercial educational purposes with display of
attribution and
copyright is granted.
Last updated: February 20, 2002
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Rationale
Select section:
Changing Illness Experience
Changing Expectations and Needs
Progressive Healthcare Response
Responding to the Opportunity
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Changing Illness Experience
Illness in the Past
Progress Fighting Disaese
Illness Today
Prolonged Illness Experience
Chronic Disease Process
Determining Prognosis
Cancer
Manifestations
Predicament
Prolonged End-of-life Experience
Sudden Unexpected Death
Predictable Decline
Slow Decline, Multiple Acute Crises
Death in the US
Leading Causes of Death
Setting of Death
Desired
Reality
Multiple Issues Cause Suffering
The Square of Care
Morbidity
Pain
Need for Assistance
Social, Financial Impact
Implications for Care
Variable Need for Care
Opportunities
For Patients
For Families
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Changing Expectations and Needs
Increased Consumer Autonomy
Picker Institute 8 Dimensions of Care
Goals, Not Problems, Drive Care
Shift to Goal-oriented Care
Expect Competence, Expertise
Expect Comprehensive Assessment
Expect Effective Communication
Expect Participation in Decision-making
Expect Timely, Continous, Coordinated Care Delivery
Expect Assistance with Caregiving
Caregiver Training, Support
Caregiver Financial Support
Alternate Settings of Care
Respite Relief
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Progressive Healthcare Response
Focus on Disease-modifying Therapy
Focus on Care of the Dying
Early Hospice
Modern Hospice Movement
Dame Cicely Saunders
Origins of "Palliative Care”
Evolution of Hospice, Palliative Care
In United Kingdom
In Canada
In United States
Convergent Evolution
Hospice, Palliative Care in US Today
Hospice Growth
Continued Unmet Opportunity
A Public Health Issue
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Responding to the Opportunity
Paradigm Shift in Thinking
Provide Concurrent Care
Consider Application to Those at Risk
Expand Services, Settings of Care
1º, 2º, 3º Model of Delivery
Expand Access to Expertise
Create Specialized Environments
Many Names, Same Focus of Care
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