Navigating the healthcare system can be challenging, especially when it comes to understanding the distinctions between palliative care and end-of-life care. While both aim to provide comfort and support to patients with serious illnesses, they are not the same.
In this blog, we will consider the key differences, legal implications, and important facts surrounding palliative and end-of-life care.
When considering palliative care and end-of-life cases it is essential to know what stage the patient was at in their care so as to establish what the reasonable standard of care was to be have been afforded.
What is Palliative Care?
Palliative care is a holistic approach aimed at improving the quality of life for patients with serious, life-limiting illnesses. It addresses not just physical symptoms, but also emotional, social, and spiritual needs. The goal is to provide relief from pain and other distressing symptoms, enhancing the patient's and their family's quality of life. This type of care is comprehensive, including pain management, emotional support, and assistance with decision-making.
Palliative care involves an interdisciplinary team of healthcare professionals, including doctors, nurses, carers, social workers, and chaplains, all working together to support the patient.
Importantly, palliative care can be provided alongside curative treatments at any stage of the illness, ensuring that patients receive the support they need throughout their journey.
Charitable groups play a significant role in palliative care, offering time, expertise, and psychological support to both patients and their loved ones. Peer support from individuals facing similar challenges can be invaluable, providing emotional solidarity and practical advice.
What is End-of-Life Care?
End-of-life care is a subset of palliative care that specifically focuses on the final weeks or months of a person’s life when the illness has advanced, and curative treatment is no longer an option.
The primary aim of end-of-life care is to ensure comfort and dignity during the remaining time. This care is primarily concerned with the last phase of life, providing intense symptom management to address pain, breathlessness, and agitation.
Additionally, end-of-life care offers significant support to the patient's family, helping them cope with the emotional and practical challenges during this difficult time. The interdisciplinary team remains essential, often including health practitioners, therapists, psychologists, and alternative therapists offering relaxing and calming treatments.
Legal Implications of Palliative and End-of-Life Care
Understanding the legal implications of palliative and end-of-life care is crucial for both patients and healthcare providers.
One critical aspect is advance care planning. In the context of palliative care, patients can express their wishes regarding future treatments and care through advance care planning, which can include a Lasting Power of Attorney (LPA) for health and welfare. There are legal requirements for wishes to be correctly documented. For end-of-life care, more immediate decisions may be made based on prior advance care plans or discussions with family and healthcare providers if the patient is unable to communicate. It’s essential that people’s wishes are documented, enabling the healthcare team to respond accordingly.
Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders are another vital legal consideration. These orders specify a patient’s wish not to undergo CPR in the event of cardiac or respiratory arrest and are respected in both palliative and end-of-life care settings. Additionally, patients receiving palliative or end-of-life care are protected under the Human Rights Act 1998, which ensures their right to privacy, dignity, and freedom from inhuman or degrading treatment.
The Mental Capacity Act 2005 provides a framework for making decisions on behalf of individuals who lack the capacity to make decisions themselves.
In my experience, medical and nursing experts are often asked to provide their opinions in various circumstances when someone is receiving palliative or end-of-life care. Our practice has investigated cases involving concerns about care planning, incorrect use of medication, poor communication with the patient and their families, inadequate community services, complaints regarding pressure injuries, poor pain management, and many other issues.
Accessibility and Public Awareness
Accessibility to palliative care is a significant concern in the UK. According to the National Institute for Health and Care Excellence (NICE), palliative care should be accessible to anyone with a life-limiting condition, not just cancer patients. Over 200 hospices provide palliative and end-of-life care across the UK, supporting patients in both in-patient units and their own homes, according to Hospice UK. Public awareness of palliative care is growing, but a study by Marie Curie found that misconceptions remain about its purpose and benefits.
Conclusion
Understanding the differences between palliative care and end-of-life care is essential for making informed decisions about healthcare in the UK. Both types of care are designed to provide comfort and dignity to patients, but they differ in timing and scope. Legal considerations such as advance care planning and DNACPR orders are vital components of these care strategies. By being informed, patients and their families can better navigate the complexities of serious illness and ensure their wishes are respected.
For more information on palliative and end-of-life care, consult resources from the NHS, Hospice UK, and NICE guidelines.
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