The term “comfort care” is often used synonymously with the term “palliative care.” Comprehensive palliative care, which includes pain and symptom management, support for patient and family, and the opportunity to achieve meaningful closure to life, is the standard of care for the dying, especially by many hospice programs. When comfort care is provided properly, it can ensure a dignified death for most incurably ill patients. Nevertheless, there are some instances when severe intolerable end-of-life suffering cannot be adequately treated without complete sedation. Most terminal suffering, even in the case of many cancer patients, can be reversed through more aggressive efforts at comfort care or by making comprehensive medical care more available. It may mean a change in priorities and difficult decisions based on information about the burdens of treatment and the patient’s prognosis. Importantly, it also means exploring what gives meaning to a patient at the end of life.
There are some limitations of comfort care, such as when a patient does not wish to be heavily sedated, comatose, or in a state of “twilight” sleep, or does not want to be completely dependent upon others for care. Some patients fear being out of control or mentally confused while waiting for death. Others with incurable respiratory problems may fear — or experience — a suffocating struggle just prior to death, which they do not wish to endure.
Medical care designed to provide comfort and dignity when curative therapy is no longer appropriate. It offers control of pain and other symptoms as well as emotional and spiritual support. This approach has been comprehensively developed within the hospice movement which provides specialized medical, nursing and support services for terminally ill patients and their families.
Palliative care refers to treatment given to patients who are incurably ill, with the aim of relieving their suffering and controlling their symptoms in the most effective way. The World Health Organization defines palliative care as:
“The active, total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems, is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families.” (WHO, 1990).
Adopted from: South Australian Voluntary Euthanasia Society (SAVES)