Republic of the Philippines

Isabela State University

City Of Ilagan, Isabela

ELECTIVE 1: HOSPICE PALLIATIVE CARE

“you matter because you are, and you matter to the end of your life, We will do all we
can not only to help you die peacefully, but also to live until you die”
-Dame Cicely Saunders
Palliative Care
“ To mitigate the sufferings of the patient, not to effect a cure”
-Macpherson, 2002

MODERN HOSPICE CARE

- Influenced by Dame Cicely Saunders - 1967, St. Christopher’s hospice in UK.
- In 1974 Florence Wald and Chaplain Ed Dobihal - first US hospice program in
connecticut.
- In 1980 Hospice and Palliative care - Clevelend Clinic and Medical Colloge of
Wisconsin.

HISTORY OF HOSPICE
- Existed in roman times - charitable for travelers in 19th century religious
influence and opened of the dying.

Palliative care
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
-WHO 2002
National Council for Palliative Care (NCPC)
- Which is the umbrella organization for setting standard in specialist palliative in
the UK.
-Principles of palliative care:
 Affirms life and dying as a normal process.
 Neither hastens postpones death
 Provides relief from pain and other distressing symptoms
 Integrates the psychological, ethical, legal, and spiritual aspect of care.
 Offers a support system to help a patient’s families cope during the patient’s
illness and in their own bereavement.
Terminologies:
 Life-limiting illness - describe illness where all activities that make a person feel
alive get restricted. Or used for diseases where death is expected as a directed
consequence.
 Hospice and hospice care - refers to the philosophy of care of the whole person
an all that matters to him / her.
 Holistic approach to care - it is care upholding all aspect of a person’s need
including psychological, physical, social and spiritual.
 Terminal care - refers to management of patients during their last few days or
weeks of life when it becomes clear that the patients is in a progressive state of
decline.
 Continuum of care - it is a concept involving an integrated system of care that
guides and support a patients with chronic illness, through a comprehensive array
of health services.
 Supportive care - is all that help the patients to maximize the benefits of
treatment and to live as best as possible with the effects of the disease.
 Quality of life - an individual’s perception of their position in life in the context
of culture and value system in which they live and in relation to their goals
expectations, standards and concerns.
 Caregivers - refers to relative or friends who take care of the patients. -
paramedical professionals.
 Multidisciplinary care - occurs when professional from a range of discipline
with different complementary skills, knowledge and experience work together to
deliver the most appropriate healthcare.
 Suffering - distress associated with events that threatens the wellbeing or
wellness of a person.
 Spiritual pain - special dimension in human that gives a purpose to life.
 Psychosocial pain - a sense of being a burden on others and no longer being
valued as a person.
 Dying with dignity - humanitarian concept that a terminally ill patient should be
allowed to have peaceful, natural and comfortable death.
 Bereavement support - they have lost someone precious and close to them and
are grieving, support is given to the family to go through this period and get back
to regular productive life.
Components of input in palliative care
CONVENTIONAL APPROACH
- Disease is the central concern
- intent -curing
- Disease a problem to be solved
- “don’t just be there, do something”
- Goal is to improve quantity of life
- Death: a failure of treatment,
to be prevented at all cost
- Valuable approach in caring for acute
episodic disease
PALLIATIVE APPROACH
-Human dignity is the central value.
- Intent- healing
- Disease an experience to be lived
- “don’t just do something... be there”
- Goal is to improve quality of living
- Death: an inevitable reality, neither to
hastened or postponed
- Valuable approach in caring for
chronic progressive disease.