Palliative Care in the ICU

palliative_care_station_small1Palliative Care is a recognized approach to care that is associated with the dying process. However, no singular definition of ‘palliative care’ seems to have been settled on. The WHO definition below is cited by many organizations and focuses on addressing pain/suffering associated with life-threatening illness.

Patients admitted to the intensive care unit are by definition, facing life-threatening illness. For these patients, focus on pain and symptom management is not optional. Any and ALL patients admitted to the ICU are effectively receiving ‘palliative care’ concurrent with treatments aimed at prolonging or reversing critical illness.

Given the WHO definition of ‘palliative care’ it is inaccurate, even irresponsible, to use the terminology only to refer to a broader goal of care (e.g. “that patient is now palliative”).

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WHO Definition of Palliative Care

“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. Palliative care: provides relief from pain and other distressing symptoms; affirms life and regards dying as a normal process; intends neither to hasten or postpone death; integrates the psychological and spiritual aspects of patient care; offers a support system to help patients live as actively as possible until death; offers a support system to help the family cope during the patients illness and in their own bereavement; uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated; will enhance quality of life, and may also positively influence the course of illness; is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.”