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Palliative care reimagined: a needed shift
  1. Julian Abel1 and
  2. Allan Kellehear2
  1. 1Department of Palliative Care, Weston Area Health Trust, Weston super Mare, UK
  2. 2Department of End of Life Care, University of Bradford, Bradford, UK
  1. Correspondence to Dr Julian Abel, Department of Palliative Care, Weston Area Health Trust, Weston Area Health Trust, Grange Rd, Weston super Mare, BS23 4TQ, UK; julian.abel{at}nhs.net

Abstract

Palliative care, since its inception over 60 years ago, has set the standard of how to care for people who are dying. Key features among these standards have been the professional development of clinical specialisms such as palliative medicine and palliative nursing; the essential addition of the multidisciplinary team to these two new specialisms that included social, spiritual and allied health workers—an outgrowth of the recognition that routine work with the dying, their carers, and the bereaved required more than solely clinical skills; and the unique partnership with communities that yielded the volunteer movement within palliative care. Professional, evidence-based symptom management and the importance of supportive care in its widest possible sense were and remain the cornerstones of the modern palliative care approach. However, the majority of people with terminal illnesses do not have access to palliative care teams, whose main focus of care remains patients with cancer. In the context outlined above this paper therefore poses two key questions: how can we provide an equitable level of care for all people irrespective of diagnosis and how can we increase the range and quality of non-medical/nursing supportive care in a context of diminishing resources? We argue that an important opportunity and solution can be found by adopting the principles of a public health approach to end-of-life care.

  • Cultural issues
  • Social care
  • Received 21 August 2015.
  • Revision received 18 December 2015.
  • Accepted 10 January 2016.

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  • Received 21 August 2015.
  • Revision received 18 December 2015.
  • Accepted 10 January 2016.
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