Palliative Care Quality Guidelines

April 29, 2004, New York, NY -- With the number of aging Americans spiraling upward over the coming decades, many more than ever before will experience life-threatening or advanced chronic illness. To address their needs, leaders in the palliative care field have developed the first national Clinical Practice Guidelines for Quality Palliative Care.

Palliative care is medical care that focuses on the relief of suffering and helping patients with advanced chronic or life-threatening illnesses and their families to experience the best possible quality of life during the course of the illness.

The new guidelines will assist the rapidly increasing number of palliative care programs established in hospitals, nursing homes, hospices and health systems deliver high-quality, state-of-the-art care for seriously ill patients and their families.

"These guidelines couldn't be more timely, with increasing numbers of Americans who suffer from advanced, chronic illness and need the relief and support that palliative care provides," said Charles von Gunten, MD, PhD, medical director, Center for Palliative Studies in San Diego, who is among the guideline's authors. "The new clinical practice guidelines will enable palliative care specialists and other health care professionals to deliver the highest quality palliative care in all settings to this rapidly expanding patient population."

Patients and Families Benefit from Best Care

"Palliative care provides quality to the patients who need it most, where and when they need it," said Betty Ferrell, PhD, RN, RAAN, Research Scientist at City of Hope National Medical Center in California. "All patients and their families should have access to it, at all stages of illness, regardless of prognosis."

What Can Patients and Families Do?

Patients and their families who face serious illness need palliative care. They can select a health care provider who is knowledgeable in palliative care or they can request a consultation for a palliative care specialist. Palliative can be delivered in all health care settings. "These guidelines are important for the public-the ultimate consumers. If the public demands palliative care, the health care system is much more likely to ensure that it is available," said Karen Kaplan, President and CEO of Partnership for Caring.

Health Care Professionals Can Provide Specialized Care

Health care professionals delivering palliative care will be able to use the guidelines to provide specialized care to their sickest and most complex patients resulting in higher patient and family satisfaction with the care they receive and with the health care system in general. The new guidelines reflect the collective experience and expertise of leading organizations and their members, including more than 50,000 health care professionals and consumers in all 50 states.

The National Consensus Project for Quality Palliative Care (NCP), which developed the guidelines, is a consortium of the American Academy of Hospice and Palliative Medicine, the Center to Advance Palliative Care, Hospice and Palliative Nurses Association, Last Acts Partnership, and the National Hospice and Palliative Care Organization.

What is Palliative Care?

The goal of palliative care is to address suffering. This means aggressively treating pain and other physical symptoms, while relieving psychological, emotional and spiritual stress, providing support for daily living, helping patients and families make difficult medical decisions, and making sure that the patient's and family's wishes for care are followed. Palliative care also coordinates care for patients and families helping them navigate a confusing and segmented health care system at a critical time. Palliative care can be delivered by specialists or by other health care professionals who seek to improve every aspect of care for their seriously ill patients.

Growth in the Field

"These new guidelines reflect the growth, maturity and a better understanding of the complexity of the palliative care field," said Diane Meier, MD, Director of the Center to Advance Palliative Care in New York City. Today, one in five hospitals has a palliative care program, one quarter of hospices provide palliative care services outside the Medicare hospice benefit and a growing number of nursing homes are establishing palliative care programs.

"Hospice programs have developed important and effective approaches to meeting the needs of patients and families, and those approaches are now being broadly applied to patients at all stages of illness through palliative care," said, Don Schumacher, PsyD, President and CEO of the National Hospice and Palliative Care Association. "Health care providers need these guidelines now to steer further growth in the field and ensure consistency across all health care settings."

The guidelines grew out of more than 20 years of research and experience into what kind of care best meets the needs of patients with advanced chronic or life-threatening illnesses, and their families. They provide detailed descriptions of appropriate means to address eight key areas: Structure and Process of Care; Physical; Psychological and Psychiatric; Social; Spiritual, Religious and Existential; Cultural; The Imminently Dying Patient; and Ethics and Law.