Defining supportive and palliative care
‘Supportive care is defined as care that:
“…helps the patient and their family to cope with cancer and treatment of it – from pre-diagnosis, through the process of diagnosis and treatment, to cure, continuing illness or death and into bereavement. It helps the patient to maximise the benefits of treatment and to live as well as possible with the effects of the disease. It is given equal priority alongside diagnosis and treatment1” (cited in NICE 2004).
Supportive care is an ‘umbrella’ term for all services, both generalist and specialist, that may be required to support people and their families / carers from diagnosis through to death and bereavement. Supportive care encompasses:
Self help and support
End of life care and bereavement care
The World Health Organisation (WHO) set out the definition of palliative care, which has underpinned the work in cancer care in the UK. Palliative care is defined as:
“…the active holistic care of patients with advanced progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is the achievement of the best quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments”.
General palliative care and specialist palliative care can be defined as follows:
General palliative care is:
“.Provided by all the usual professional carers of the patient / family as an integral part of routine clinical practice. It is provided for patients and families with low to moderate complexity of palliative care need in all clinical settings”.
Specialist palliative care is:
“.Provided by accredited specialist in palliative care, who are working in multi-professional Specialist Palliative Care (Macmillan) teams. It is provided in specialist palliative care units, hospices, hospitals and in people’s homes. It is provided for patients and families with high complexity of palliative care need”.
NICE Guidance1 highlights that although palliative care encompasses many of the elements identified in ‘supportive care’, there are well-defined areas of expertise within specialist palliative care to which patients and carers need access, such as interventions to respond to: