Published online by Cambridge University Press: 19 May 2010
INTRODUCTION TO PALLIATIVE CARE
Although the concept and provision of palliative care is as old as medicine itself, it is only recently that palliative care programs have increased in both visibility and numbers. Palliative care is an interdisciplinary team approach to optimizing symptom management and quality of life for those with serious or life-threatening illnesses. It is care that addresses the physical, psychosocial, and spiritual needs of the patient and family according to their preferences and cultural beliefs. This differs from most allopathic care, which is directed toward the diagnosis and cure of disease. The notion and practice of palliative care continues to evolve and broaden. The four main attributes of palliative care include: 1) total, active, and individualized patient care, 2) support for the family, 3) an interdisciplinary approach, and 4) effective communication.
THE GROWTH OF PALLIATIVE CARE
Based on changes in the leading causes of death during the past century, a medical care system that was initially designed to focus on acute care is now becoming dominated by patients with incurable, progressive, and debilitating illnesses. The current health care system excels at providing acute care for problems such as trauma and sudden illness; however, it is inadequately prepared to provide comprehensive, coordinated care for those with chronic conditions, especially for those near the end of life. This is epitomized in the landmark study sponsored by the Robert Wood Johnson Foundation in the mid-1990s, called the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.