Palliative Care vs. End-of-Life Care: The Critical Distinction 

These two concepts are constantly being merged. 
And frankly, it is a stain on the professional expertise of those who use them interchangeably without any nuance. 
It seems almost everyone is guilty of this everywhere, in books, on websites, in training programs, on social media etcetera. 

Please let me remind you of this distinction...
Not all palliative care is related to the end of life. 
And while end-of-life care is undeniably a form of palliative care, it is a highly specialized extension of it, a completely independent discipline.

I have dedicated an entire chapter to this very topic in my book,

 “Dying, the Last Miracle of Life”.
 

On this website, I have decided to share a small preview, straight from the book, here.

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<snip>

Palliative care is frequently discussed in courses, books, and on websites. 
It is a valuable subject that garners a great deal of interest, yet a persistent misconception exists around it. 
Many people believe that the topic of “palliative care” relates exclusively to the end of life and the guidance during that phase. However, this is not the case. 

Palliative care is care for people with conditions that can no longer be cured or reversed. Care for people with Multiple Sclerosis (MS), Alzheimer's, cerebral haemorrhages with debilitating residual symptoms, ALS, Parkinson's, COPD, diabetes, most types of cancer, and so on…
All of these individuals receive palliative care, yet you rarely encounter these and many other clinical pictures in courses, training programs, websites, and books that focus on “palliative care.”

 You see, there is a distinction between Palliative care and Curative care.

 Curative care contains the word “cure”, which translates to healing or recovery.
Here, physicians and healthcare providers are essential in curing the client. Following recovery, the patient no longer suffers from the disruption to their health and functioning. And if people do retain residual symptoms, as is often the case, for instance, with patients after cancer treatment, then palliative care becomes a necessary continuation of their journey.

 The term 'palliative care' originates from the word “palliation”, which means soothing or relief. It is derived from the Latin word “pallium”, meaning 'cloak.'
Therefore, palliative care, offers soothing or relief, as if you are placing a cloak over someone's shoulders to help them better bear the circumstances of their condition.

 End-of-life care, on the other hand, is an entirely distinct discipline of care.

Admittedly, it frequently has a palliative history, since not everyone passes away from old age. And it naturally shares the characteristics of palliative care because, the healthcare provider and physician offer soothing and relief during the process.
End-of-life care is therefore the specialized extension of palliative care. 
It is a standalone, distinct discipline. With its own specific observations and specialized interventions.

 In my view, the weight and highly specialized nature of end-of-life care are insufficiently recognized.
The hallmark of high-quality end-of-life care is, first and foremost, knowledge of the process.

The shutting down of the body follows a specific order. 
The art of end-of-life care lies in recognizing this sequence within the client, and subsequently anticipating and reacting appropriately if this order is disrupted by expected and unexpected complications. 
Beyond providing care and educating the client and family, the task of the nursing staff is to observe keenly and communicate these findings effectively with the physician.

Furthermore, Advance Care Planning, which will be explained later on in this book, provides an excellent framework for preempting complications.

These observations are presented to the attending physician, after which interventions are implemented to safeguard the comfort of both the client and their family.

It does not always go smoothly… 

A physician arriving at the bedside sometimes operates, consciously or subconsciously, in a "curative mindset." The physician wants to fix the situation. They are also frequently receptive to the anxieties of the family and wish to alleviate them. 

For instance, the family might tell the doctor that the client has not had a drink in days. I have sometimes encountered terminal clients with hypodermoclysis lines (subcutaneous infusions) placed in their thigh—even when the blood circulation had already withdrawn above the legs! 

Because the fluid can no longer be carried away by adequate circulation, a fluid buildup occurs in that leg and potentially elsewhere in the body. 

Alternatively, a nasogastric tube is inserted because the client has not consumed food for a very long time… though we have read earlier  why this is precisely the case. 

This inflicts physical harm upon the dying body, resulting in a complicated and uncomfortable course of an inevitable process that, at that point, simply continues. 

And let me be clear: when a physician applies interventions from a curative perspective, these are correct medical actions. Most physicians are trained to sustain life. 

But in end-of-life care, the physician must shift their clinical reasoning. 
In end-of-life care, the physician must support the body in winding down, meaning, in shutting this body down. 
And that requires a fundamentally different perspective in practice… 

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Read the whole chapter and much more… so…

 If you want to add the complete, detailed explanation of the human dying process to your digital or physical bookshelf?

You can find it via the links below:
 
Amazon
Books2Read