Introduction to Hospice and Palliative Medicine

Hospice and palliative medicine is a relatively new specialty born of out of Cicely Saunders' work and other researchers in the UK. Palliative care and hospice focus on whole person care including physical, psychological, psychosocial, and spiritual issues associated with serious and chronic illness. The overall goal is to ensure superior quality of life and comfortable, dignified deaths. Palliative care is appropriate at any age and any stage of the disease, and is often provided alongside curative treatment, whereas hospice focuses on comfort care in patients with a prognosis of 6 months or less if the disease runs its natural course. Specialist palliative care providers are experts in communication and complex symptom management. The ultimate goal is to align patient and family's values, priorities, and preferences with medical treatments. There is a high demand for palliative care specialists with many patients living longer with chronic disease and an aging, high-cost society. Yet, there are not enough palliative care specialists to meet this demand. Primary palliative care is recommended for all chronically ill patients. The benefits of hospice and palliative care for patients, families, caregivers, health care organizations, and other members of the health care team are numerous. Nevertheless, there remains much work to do to break down barriers to this high-quality care.