Extending palliative care to chronic conditions

Addington-Hall, J. (2005) Extending palliative care to chronic conditions. European Journal of Palliative Care, 12 (2, Supplement), 14-17.

Abstract

Since its inception in the 1960s, hospice care has been primarily focused on the care of terminally ill cancer patients. The lack of effective remedies for pain and other symptoms, poor communication with healthcare professionals, and inadequate practical and emotional support resulted in considerable distress for patients and families, and provided much of the impetus for the original development and rapid spread of what has become the hospice movement. This initial focus on cancer, together with rapid advances in science and management of pain, allowed swift progress to be made in both the science and the practice of palliative care. As the principles and practice of hospice care have been disseminated across the world, they have been adapted to fit local circumstances. In some settings there has been historically greater emphasis on, and provision for, people with conditions other than cancer, particularly in those countries where pioneers and champions of hospice care have come from backgrounds outside oncology. Nevertheless, in many settings, hospice and palliative care have been (and remain) synonymous with terminal cancer care. This situation is increasingly challenged, especially in those countries where hospice care has the longest history. In this paper, I will review the reasons for this and consider the obstacles to extending the borders of palliative care beyond cancer.

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