World Health Organisation definition of palliative care:
“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”.1
Palliative care aims to:
- Affirm life and regard dying as a normal process
- Provide relief from pain and other distressing symptoms
- Integrate the psychological and spiritual aspects of patient care
- Offer a support system to help patients live as actively as possible until death
- Offer a support system to help the family cope during the patient’s illness and in their own bereavement2
Each year approximately 45,000 new patients receive palliative care in England, Wales and Northern Ireland, provided through in-patient care, hospital support services, community care, day care and outpatient care. Approximately 90% of those people receiving palliative care in England, Wales and Northern Ireland have cancer. Those who do not have cancer and are receiving palliative care most commonly have heart disease, stroke, motor neurone disease and multiple sclerosis.
3
Pain is the most visible sign of distress in patients receiving palliative care. It occurs in up to 70 percent of people with advanced cancer and about 65 percent of people dying from non-malignant disease.
4 Opioids are essential and well-established treatments to manage pain and other symptoms encountered in palliative care. They act centrally to effectively control pain, although they may also have side effects including drowsiness, nausea, vomiting and constipation.
1. Sepúlveda C, Marlin A, Yoshida T, Ullrich A. Palliative Care: The World Health Organization’s Global Perspective. J Pain Sym Man. 2002; 24: 91-6
2. The National Council for Palliative Care. Palliative Care Explained (Accessed 30 April 2008) Available at http://www.ncpc.org.uk/palliative_care.html
3. The National Council for Palliative Care, National Survey of Patient Activity Data for Specialist Palliative Care Service, MDS Full Report for the year 2005 – 2006
4. Colvin L, Forbes K, Fallon M; Difficult pain. BMJ. 2006; 332 (7549):1081-3.