Advance directives are a patient’s formal or informal instructions concerning expectations of care and choice of treatment options in response to potential illnesses or conditions (legal connotations vary by jurisdiction; includes a living will).
Alternate / Complementary Integrative Therapies
Alternate or complementary integrative therapies are terms often used to describe independent healing systems outside the realm of conventional medical theory and practice.
A caregiver can be broadly defined as anyone who provides care. This definition can be further broken into two categories of caregivers, formal and informal.
Formal caregivers are members of an organization and accountable to defined norms of conduct and practice. They may be professionals, support workers, or volunteers. They are sometimes called ‘providers’.
Informal caregivers are not members of an organization. They have no formal training, and are not accountable to standards of conduct or practice. They may be family members or friends.
The term family refers to those closest to the patient in knowledge, care and affection and may include:
- the biological family
- the family of acquisitions (related by marriage/contract)
- the family of choice and friends (including pets)
The patient defines who will be involved in his/her care and/or present at the bedside.
Hospice Palliative Care
Hospice palliative care provides physical, psychological, social, spiritual and practical support to people with life-threatening illness and to their loved ones. Care teams include physicians, volunteers, nurses, spiritual counsellors, friends and family. It can be provided at home, in hospitals, nursing homes or freestanding hospice facilities.
Hospice palliative care helps make a very difficult life passage both manageable and meaningful for people facing serious illness or death as well as for their loved ones.
In light of Canada’s aging population and ongoing health care reform, hospice palliative care is becoming an increasingly essential service to cope with the growing demand for compassionate, high quality and cost-effective end-of-life care. The Canadian hospice palliative movement is still in its formative stages and requires significant help to meet this enormous need.
World Health Organization 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.
Illness is an absence of wellness due to disease, another condition or aging. Illness can be further categorized as acute, chronic, advanced and life-threatening.
An acute illness is one that is recent in onset and likely to be time-limited. If severe, it could be life threatening.
A chronic illness is likely to persist for months to years. With progression it may become life threatening.
An advanced illness is likely to be progressive and life threatening.
A life-threatening illness is likely to lead to death in the near future.
A provider is a formal caregiver who is a member of an organization and accountable to defined norms of conduct and practice. They may be professionals, support workers, or volunteers.
A volunteer is a person who freely gives of his/her time, talent, and energy. Volunteers are members of an organization and accountable to that organization’s standards of conduct and practice.