Palliative and End-of-Life Care

Nurses perform a primary role in the assessment and management of pain and other symptoms. To provide comprehensive care, they explore patients’ and families’ basic beliefs and values regarding health, illness and death, and take into consideration cultural, religious and ethnic backgrounds. Palliative care principles and guidelines encompass the physical, psychological, spiritual and practical burden of illness and focus patients’ and families’ needs, values and beliefs in the goals of care.

Palliative care is not meant to replace curative care, though it does assume a greater role as patients advance in the disease. Palliative care affirms life by supporting the patients’ and families’ goals for the future, including their hopes for cure or life-prolongation, as well as their hopes for peace and dignity throughout the course of illness, the dying process and death.1

In the past, the concept that life-sustaining and palliative care were two distinct entities has given way to the understanding that they must exist on the same continuum. To provide optimal, quality care, the science and skills for prolonging life, as well as palliative therapies must be embedded into the management of critically ill patients. For patients to receive quality care, palliation must be included throughout the trajectory of illness.

The goal of palliative care is to achieve the best possible quality of life through relief of suffering, control of symptoms and restoration of functional capacity while remaining sensitive to personal, cultural and religious values, beliefs and practices.²