What is end of life care?

There are a number of terms used when describing care that people may need as they approach the end of life. There is a lot of overlap and often they are used synonymously so it can be confusing.

End of life care is about the total care of a person with an advanced incurable illness and does not just equate with dying. The end of life care phase may last for weeks, months or years.

End of life care is defined as care that helps those with advanced, progressive, incurable illness to live as well as possible until they die.

Supportive and palliative care

End of life care enables the supportive and palliative care needs of both patient and family to be identified and met throughout the last phase of life and into bereavement. It includes the management of pain and other symptoms and the provision of psychological, social, spiritual and practical support.

Supportive care is defined as care that helps the patient and their family to cope with their condition and its treatment from pre-diagnosis, through the process of diagnosis and treatment, to cure, continuing illness or death and into bereavement.

Palliative care is the active total care of patients whose disease is unresponsive to curative treatment. Control of pain and other symptoms and support to manage psychological, social and other problems are paramount. The goal of palliative care is achievement of the best quality of life for patients and their families.

  • A person may receive supportive care for a variable amount of time even when death is not anticipated.
  • An example may be someone who has had treatment for cancer and is now considered cured.

Another example is someone with chronic obstructive pulmonary disease who has ongoing illness, is receiving active treatment and is not expected to die.

Palliative care comes into the picture when the person's condition deteriorates and active treatment does not control the disease. Here progressive deterioration and death is anticipated and the emphasis of care moves from active treatment of the disease to treatment to give comfort and control symptoms such as pain.

Sometimes treatment that is usually used to actively treat disease may be used to help with symptom control as part of palliative care. An example is radiotherapy which is often used to treat certain types of cancer (active treatment of the disease) being used to help with pain control (palliative treatment to control pain). Another example is chemotherapy used to treat types of cancer being used as part of palliative care to shrink the cancer and help to relieve symptoms caused by pressure.

End of life care encompasses supportive and palliative care.