Palliative Care in Nursing

Palliative Care

According to the World Health Organization definition of palliative care ("palliative care") are working in an active and full of patients suffering from a disease that does not respond to specific treatments and whose direct consequence is death. The control of pain and other symptoms of the psychological, social and spiritual needs is of paramount importance. The goal of palliative care is to achieve the best possible quality of life for patients and their families. Some palliative interventions are also applicable as early in the disease, in addition to cancer treatment.

The term is derived from "ball", or cover, concealment of a pallium , which in ' Ancient Greece and in the ' Ancient Rome was the woolen cloth that rested on his shoulder and draped around the body, above the tunic.

What are the goals of palliative care?

The main purpose of palliative care is to give meaning and dignity to the patient's life until the end, first relieving his pain, and helping with the holders of not strictly medical, which are equally necessary, as shown by the above definition. Still, Dr. Saunders, he loved to repeat to his patients, "You are important because you are and you are important to the end." This type of medicine, therefore, is not just a simple medical treatment, but it can provide a path of reconciliation and peace than the patient's life and the people around him. Therefore, it is unanimous opinion among international experts that palliative care is the best answer to euthanasia.

The goals of palliative care are well summed up thus:
• Affirm the value of life, whereas death as a natural event;
• do not extend or shorten the life of the patient;
• to provide relief from pain and other symptoms;
• also consider the psychological and spiritual arpects;
• offer a support system to help patients live as actively as possible until death;
• help the family of the sick to live with the disease and then with the mourning.

Who needs it?

It is estimated that every year, about 250 000 people that should be followed with a palliative approach is well 160 000 cancer patients, while the other 90,000 would be part of the sphere of chronic degenerative diseases. These are designed to grow with the continued aging of the population. Therefore, we must turn very soon, when a diagnosis is communicated by the medical prognosis, the palliative care approach. This choice, not to reduce palliative care, as it often still happens, the so-called care of the last days, usually no more than two weeks, requires a synergy between the family doctor, oncologist and medical experts in palliative care (it is noted that does not exist yet defined a postgraduate degree, but you get to do palliative care from locations as diverse as oncology, anesthesia or geriatrics)

The total pain

So Dr. Saunders called the total pain, as an approach to care that affects not only the physical pain of the patient, but all aspects that contributed to acute. The Saunders realized he was treating the wounded of World War II. From here, he had developed, through rigorous study and clinical observation, that if given a regular pain medication could have provided an extremely beneficial to patients. But the single medical therapy was then added to a concrete psychological, social and spiritual: these, together with medical therapy are the four pillars of palliative care. The total pain is a core concept of palliative care, you need to know to understand the wealth. It is an approach in a sense revolutionary, because you can look at the whole person.


Hospice is a residential facility where the incurably ill and his family can find relief for a limited period and then return home or live in comfort for the last days of life. It has some specific features: free access for family members (the rooms are equipped with beds for them to sleep, when necessary, within the structure), the possibility of sharing some spaces, such as the so-called herbal teas, the heat of ' furniture (usually in the rooms there is written the name of the patient, and have never designated number with a cold). There are either in hospitals or in specific sites, characterized by being immersed in a scenery of nature.

The home care

You can activate the same type of care you receive hospice care at home also. It is recognized that any person is in the final phase of life certainly prefer to spend it at home. It is important that there are some basic requirements, however, first and foremost the presence of a family member who assumes the role of caregiver (from ' English : "he who gives assistance"), which is formed by the operators of the patient care operations easier. A home is going to visit periodically, depending on the stage of disease may be more or less frequently, the so-called home palliative care team, which includes palliative care doctor, nurse, the ' social workers , psychologist . But beyond the periodic visit to a good team of palliative care home shall ensure the availability in the 24-hour telephone availability.

The basic laws for the movement of palliative care are two. The first had as its primary purpose the financing of hospice care in order to encourage the birth and development, then actually took place in 2000. The second law has instead wished to sanction the establishment of the network of palliative care, or the integration of hospice care and home.


Important role in palliative care has the world of volunteering. The main symbols are grouped under the Federation of palliative care . A true pioneer in this field was the Floriani Foundation , working in Milan in this field since the mid-70s.