Palliative Care Key Terms

A

Acute pain
Pain that has a known cause and occurs for a limited time. It usually responds to analgesic medications and treatment of the cause of the pain.

Addiction
A commonly used term describing a pattern of drug use that indicates physical or mental dependence. It is not a diagnostic term and is no longer used by the World Health Organization (WHO).

Advance medical directives
Used to give other people, including health care providers, information about a patient’s own wishes for medical care. Advance directives are important in the event patients are not physically or mentally able to speak for themselves and make their wishes known. The most common types of advance directives are the living will and the durable power of attorney for health care. A Do Not Resuscitate (DNR) is also a form of an Advance Medical Directive.

Analgesic medications
Medications used to prevent or treat pain.

B

Bereavement
The act of grieving the loss of a significant other.

C

Cancer
An abnormal growth of cells which tend to proliferate in an uncontrolled way and, in some cases, to metastasize (spread).

Caregiver
Any person who provides care for the physical, emotional, or spiritual needs of a family member or friend.

Chronic pain
Pain that occurs for more than one month after an injury has healed, that occurs repeatedly over months, or is due to a lesion that is not expected to heal.

Complementary therapies
Approaches to treatment that are outside of mainstream medical practices. Complementary therapy treatments used for pain and/or comfort include: acupuncture, low-level laser therapy, meditation, aroma therapy, Chinese medicine, dance therapy, music therapy, massage, herbal medicine, therapeutic touch, yoga, osteopathy, chiropractic treatments, naturopathy, and homeopathy.

Community based care
Medical and social service care often provided by volunteer trained members of the community.

D

Death
The end of life in a biological organism, marked by the full cessation of its vital functions.

Do Not Resuscitate (DNR) orders
A DNR is a medical directive that gives consent from the patient, his/her advocate or from a medical physician that the patient is not to be treated for cardiac or respiratory arrest. This directive is used when treatment of the patient will not be beneficial or successful to the quality or longevity of the patient’s life. This is usually the case in the seriously and terminally ill, and/or the frail and elderly. These directives do not mean that comfort measures will be withheld.

Dignity
The quality of being worthy, honored, or esteemed. Human rights are based on inherent human dignity and aim to protect and promote it.

Durable power of attorney
A person who is dying may appoint someone else to manage their finances and to make economic decisions on their behalf. This person is referred to as the “agent.”

E

End-of-life care
Doctors and caregivers provide care to patients approaching the end of life that is focused on comfort, support for the family, and treatment of psychological and spiritual concerns.

Essential medicines
Medicines that satisfy the priority health care needs of the population. Essential medicines are intended to be available at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford.

Ethics
A system of moral principles and rules that are used as standards for professional conduct. Many hospitals and other health care facilities have ethics committees that can help doctors, other healthcare providers, patients, and family members in making difficult decisions regarding medical care. This may vary with religious and cultural backgrounds.

G

Grief
The normal process of reacting to a loss. The loss may be physical (such as a death), social (such as divorce), or occupational (such as a job). Emotional reactions of grief can include anger, guilt, anxiety, sadness, and despair. Physical reactions of grief can include sleeping problems, changes in appetite, physical problems, or illness.

H

HAART
Highly active anti-retroviral therapy.

Health care proxy
A written instrument in which an individual legally delegates authority to another person to make certain health-related decisions on their behalf.

Home based care
Medical and social care provided by trained health care professionals or volunteers in a person’s home.

Hospice
A care program that provides a centralized program of palliative and supportive services to dying persons and their families, in the form of physical, psychological, social, and spiritual care; such services are provided by an interdisciplinary team of professionals and volunteers who are available at home and in specialized inpatient settings.

Hospice care
Care designed to give support to people in the final phase of a terminal illness, and focused on comfort and quality of life, rather than a cure. The goal is to enable patients to be comfortable and free of pain so that they live each day as fully as possible. Aggressive methods of pain control may be used. Hospice programs generally are home-based, but they sometimes provide services away from home — in freestanding facilities, in nursing homes, or within hospitals. The philosophy of hospice is to treat the whole person by providing support for the patient’s emotional, social, and spiritual needs, as well as addressing medical symptoms.

I
Informed consent
The process of making decisions about medical care that is based on factual, open, and honest communication between the health care provider and the patient and/or the patient’s family members.

L

Life-limiting illness
An illness with a prognosis of a year or less to live.

Life-threatening illness
An illness serious enough that a patient may die.

Living will
A legal document which outlines the direction of medical care a patient wishes to have or not to have. The living will is used only if the patient becomes unable to make decisions for him/herself, and will be carried out as the patient has directed in the document.

M

Medical power of attorney
A document that allows any individual to appoint another person to be their agent and make decisions for them should they become unable to make decisions for themselves.

Multidisciplinary team
A group of individuals representing different medical disciplines who work together to care for a patient and family.

N

Nursing home
A residential facility for persons with chronic illness or disability, particularly older people who have mobility and eating problems. This is also called a convalescent home or long-term care facility.

Nutrition Hydration
Intravenous (IV) fluid and nutritional supplements given to patients who are unable to eat or drink by mouth, or those who are dehydrated or malnourished.

O

Opioid
A type of medication related to opium. Opioids are analgesics used in acute and chronic pain. Opioids include morphine, codeine, and a large number of synthetic (man-made) drugs like methadone and fentanyl.

Opportunistic infections
Infections caused by organisms that usually do not cause disease in a person with a healthy immune system, but can affect people with a poorly functioning or suppressed immune system.

P

Pain
An unpleasant feeling that may or may not be related to an injury, illness, or other bodily trauma. Pain is complex and differs from person to person, as related to the individual’s pain threshold.

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.

Palliative care for children
Represents a special, albeit closely related field to adult palliative care for children with life threatening or chronic disorders and their families. Includes active total care of the child’s body, mind, and spirit; family support; and a multidisciplinary approach that includes the family and makes use of available community resources.

Palliative care standards
Standards reflecting the level of care a patient and family can expect to receive when dealing with a diagnosis of a life-limiting illness.

Permanent guardianship of minor children
Offers a parent the option of permanently placing their child (a minor) in the care of another person.

Power of attorney for personal care
A legal document that specifies one or more individuals a patient would like to make medical decisions on his/her behalf if unable to do so on their own.

Psychology
Science dealing with phenomena of the mind, the conscious subject, or self.

Psychosocial care
Care given to meet a constellation of social, mental health, and emotional needs.

R

Rehabilitation
Treatment for an injury, illness, or pain with the goal of restoring partial or full function.

S

Social work
Work carried out by professionals concerned with social problems, their causes, their solutions, and their human impacts. Social workers work with individuals, families, groups, organizations, and communities, as members of a profession committed to social justice and human rights.

Spiritual care
Providing the necessary resources to address and support people’s values and beliefs, provided these values and beliefs place no individuals at risk. It is based on treating each person with respect and dignity, promoting love, hope, faith, and helping vulnerable people to find the strength to cope at times of life crises when overcome by despair, grief, and confusion.

Suffering
Absence of any power to control or to meaningfully influence a perceived process of one’s own
disintegration.

Symptom management
Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of symptom management is to prevent or treat as early as possible the symptoms of the disease, side effects caused by treatment of the disease, and psychological, social, and spiritual problems related to the disease or its treatment. Also called palliative care, comfort care, and supportive care.

T

Terminal
A progressive disease that is expected to cause death.

Treatment withholding
When treatment is considered to be ineffective, disproportionate, or of no value to the patient’s quality of life, it may be withdrawn or withheld.

Treatment withdrawal
The ending of treatment that is medically futile in promoting an eventual cure or possible control of the disease.

W

Will
A legal document that allows a person to leave any portion of his/her estate and any specific positions to any other person or organization.

Withholding care
Not offering a specific treatment to a patient.

Withdrawing care
Withdrawing a treatment that has already started in a patient.