Page 404 - Encyclopedia of Nursing Research

PAllIATIve CARe n 371

• offers a support system to help the fam-
Palliative Care ily cope during the patient’s illness and in
their own bereavement; P
• uses a team approach to address the needs
The goal of palliative care is to prevent of patients and their families, including
and relieve suffering and to support the bereavement counseling, if indicated;
best possible quality of life for patients • will enhance quality of life and may also
and their families, regardless of the stage positively influence the course of ill-
of the disease or the need for other ther- ness; and
apies (National Consensus Project [NCP] • is applicable early in the course of ill-
for Quality Palliative Care, 2009). Palliative ness, in conjunction with other therapies
care expands traditional disease-focused that are intended to prolong life, such as
medical treatments to include the goals of chemotherapy or radiation therapy, and
enhancing quality of life for patient and includes those investigations needed to
family, optimizing function, helping with better understand and manage distressing
decision making, and providing opportu- clinical complications.
nities for personal growth. An Institute of
Medicine (IOM) report on end-of-life care At the turn of the twentieth century,
has called for models of care that implement Americans died from diseases such as yel-
palliative care concurrently with disease- low fever, small pox, diphtheria, and chol-
focused care earlier in the course of disease, era. Death was often rapid with little time
patient-focused care, and self-management to say goodbye to loved ones. In 1900, life
(IOM, 1997). expectancy was less than 50 years of age
The NCP for Quality Palliative Care for men and women, whereas in the year
(2009) recognized that multidimensional 2000, the median age of death was 77 years
support of patients and their loved ones old. Currently, Americans are struggling
is essential to quality palliative care. The to develop a health care system that is both
leading palliative care organizations and cost-effective and can ensure a “good life”
professionals involved in the creation and a “good death.”
of this document recognized the impor- Two landmark studies from the
tance of integrating palliative care as part 1990s, specifically, the Study to Understand
of the continuum of care. These reports Prognosis and Preferences for Outcomes and
support inclusion of palliative care as Risks of Treatments (SUPPORT Principal
a mechanism to meet patient and fam- Investigators, 1995) and the IOM’s (1997)
ily needs and their ability to take care of report Approaching Death: Improving Care at
their health. the End of Life, provide evidence of the need
Palliative care to improve the care of the dying in America.
The fear of experiencing a “bad death”
• provides relief from pain and other dis- seemed warranted by the conclusions of a
tressing symptoms; 5-year study of the end-of-life care received
• affirms life and regards dying as a normal by 9,000 dying hospitalized patients. The
process; Study to Understand Prognosis and Preferences
• intends neither to hasten nor postpone for Outcomes and Risks of Treatments
death; (SUPPORT Principal Investigators, 1995)
• integrates the psychological and spiritual was designed both to increase understand-
aspects of patient care; ing of hospitalized dying and to devise
• offers a support system to help patients an intervention to promote more humane
live as actively as possible until death; care of dying patients. The SUPPORT data