Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

What are Palliative, Hospice and End-of-Life Care?
  • Palliative care is both a philosophy and an approach to care. Although the terms palliative care, hospice care and end-of-life care are often used interchangeably, there are differences among them.
  • Palliative care is not restricted to care during the last months or days of life. Rather, palliative care can be used in conjunction with curative treatments. 
     
  • Hospice care, on the other hand, usually refers to the last months of life and brings with it an association with the place of care as a specialized facility.
     
  • End-of-life care more accurately reflects the emphasis on the last days and hours of life
     
  • The Canadian Hospice Palliative Care Association (CHPCA) defines hospice palliative care as an approach to care that aims to: “Relieve suffering and improve the quality of living and dying. Such care approach strives to help patients and families:  
      • Address physical, psychological, social, spiritual and practical issues, and their associated expectations, needs, hopes and fears;
      • Prepare for and manage self-determined life closure and the dying process; and
      • Cope with loss and grief during the illness and bereavement” (Ferris et al., 2002, p. 17)
  • Within the palliative care philosophy, death is viewed as a normal process; thus, the aim of palliative care is to neither hasten nor postpone death. End-of-life care (CHPCA, 2002):
      • Encompasses care of the whole person, including his/her physical, psychological, social, spiritual and practical needs.
      • Ensures that care is respectful of human dignity.
      • Supports meaningful living as defined by the individual.
      • Tailors care planning to meet the individual’s goals of care.
      • Recognizes the individual with life-limiting disease and his/her family as the unit of care.
      • Supports the family to cope with loss and grief during the illness and bereavement periods.
      • Respects the individual’s personal, cultural and religious values, beliefs and practices in the provision of care.
      • Values ethical principles of autonomy, beneficence, non-maleficence, justice, truthfulness and confidentiality.
      • Recognizes the individual as autonomous, who has a right to end-of-life care and to make decisions regarding his/her care to the degree he/she desires.
      • Recognizes the importance of a collaborative interprofessional team approach to care, and also recognizes the efforts of non-health-care professionals (e.g. volunteers, faith leaders).