Palliative care is often misunderstood. These definitions will help you understand some common palliative care terms and concepts.
Hospice palliative care and palliative care are often used to mean the same thing.
Hospice Palliative Care
- Refers to an approach to care, as well as a philosophy of care.
- Is appropriate for any individual and/or family living with, or at risk of developing, a life-threatening illness.
- Includes end-of-life care, but is not limited to the time immediately before death.
The term “palliative care” can be used in different ways. Using common language can help maintain a person-centred approach.
- Do not use palliative care as a label for patients or as a category of patients. A person may have palliative care needs, or they may receive a palliative approach to care.
- Palliative care is not a phase or stage of a person’s illness. Palliative care is appropriate at any time a person with a life-limiting illness has unmet needs, and a palliative approach to care can be introduced as early as the time of diagnosis.
The term “hospice” can refer to a variety of specific services, supports and care settings:
- Hospice residences create a home-like environment for patients who are at the end of their lives and need around-the-clock care, best provided in a specially focused care setting.
- Visiting hospices offer care through out-patient facilities or by travelling to a patient’s home.
- Virtual hospices offer online resources to members of the public on palliative care, advance care planning and other topics relevant to the last stages of life.
End-of-life care refers to care for people in decline who are expected to die in the near future:
- Active care that helps patients and families prepare for death, ensure comfort and make care decisions consistent with the person’s prognosis and goals of care.
Medical Assistance in Dying (MAiD)
The relationship between palliative care and Medical Assistance in Dying (MAiD) is often misunderstood.
- The vast majority of patients who are considering or asking for MAiD services also have palliative care needs. These patients and their families should get the full complement of palliative care services required to meet those needs throughout their illness.
- While both palliative care and MAiD help to relieve suffering, they each have a different way to doing so. Palliative care focuses on improving quality of life and managing symptoms to help people to live and die well. MAiD aims to ease suffering by helping an eligible person (as defined by legislation) end their life, when they request it, by administering medications.
For more information on MAiD, visit Medical Assistance in Dying on the Ministry of Health website.
Advance Care Planning
Advance Care Planning is a 2-step process by a capable person:
- Identify their future Substitute Decision-Maker(s).
- Share with that Substitute Decision-Maker their wishes, values and beliefs about future care. This prepares the Substitute Decision-Maker to make health care decisions for the person when they become incapable of making their own decisions.
Goals of Care Discussions
Goals of Care Discussions are between a provider and a capable patient (or the incapable patient’s Substitute Decision-Maker). These discussions focus on the following:
- Making sure the patient understands the serious (and sometimes incurable and progressive) nature of their illness.
- Helping the health care provider to understand the patient’s values and the goals they have for their care.
Health Care Consent
- An informed and contextualized decision involving a mentally capable person and a health care provider, as outlined in the Ontario Health Care Consent Act.
- Health care providers proposing treatment must get informed consent from either a capable patient or their Substitute Decision-Maker if the patient is not capable.
- Ontario law requires consent even where a patient has engaged in advance care planning or has expressed their wishes in a written document.
- In Ontario, the terms “advance directive” and “living wills” are not contained in the Health Care Consent Act and should not be used.
To learn more about Ontario‘s specific requirements for Advance Care Planning, Goals of Care and Health Care Consent, visit speakupontario.ca.
For more concepts, terms and principles related to palliative care, download Key Palliative Care Concepts and Terms (PDF).