HPCFM Glossary of Terms
This glossary (a work in progress) is designed to aid in the understanding concepts, issues and information relating to hospice and palliative care.
If there's a term not listed here, let us know by submitting it to email@example.com. Check back for updates and additions.
Advanced Directives: These directives pertain to treatment preferences and the designation of a surrogate decision-maker in the event that a person should become unable to make medical decisions on their own behalf. Advance directives generally fall into three categories: living will, power of attorney and health care proxy.
Bereavement: The act of grieving someone's death. Bereavement is the total response to a death and includes the process of recovery or healing from the death. Although there are similarities in the ways people respond to grief, there are also marked differences. Each person will grieve and recover in there own way and time.
Caregiver: Any person who provides care for the physical and emotional needs of a family member or friend.
Cancer: An abnormal growth of cells which tend to proliferate in an uncontrolled way and in some cases to metastasize.
Cardiopulmonary Resuscitation: (CPR) The emergency substitution of heart and lung action to restore life to someone who appears dead. The two main components of conventional cardiopulmonary resuscitation (CPR) are chest compression to make the heart pump and mouth-to-mouth ventilation to breath for the victim.
Complementary medicine: Approaches to medical treatment that are outside of mainstream medical training. Complementary medicine treatments used for pain include: acupuncture, low-level laser therapy, meditation, aroma therapy, dance therapy, music therapy, message, therapeutic touch, yoga, osteopathy, chiropractic treatments, naturopathy and homeopathy.
Dementia: The significant loss of intellectual abilities such as memory capacity severe enough to interfere with social or occupational functioning.
Delirium: Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment and confused thinking. The onset of delirium is usually sudden, often within hours or a few days. Delirium can usually be traced to one or more contributing factors, such as a severe or chronic medical illness, medication, surgery, or drug or alcohol abuse. The symptoms of delirium and dementia are similar and input from a family member or caregiver may be important for a doctor to make a diagnosis.
Durable Power of Attorney: This is a type of advance medical directive in which legal documents provide the power of attorney to another person in the case of an incapacitating medical condition.
Do-Not-Resuscitate Order: (DNR) A DNR order is a physician's written order instructing healthcare providers not to attempt cardiopulmonary resuscitation (CPR) in case of cardiac or respiratory arrest. A person with a valid DNR order will not be given CPR under these circumstances. Although the DNR order is written at the request of a person or his or her family, it must be signed by a physician to be valid.
End-of-Life care: Doctors and caregivers provide care to patients approaching the end of life that is focused on comfort, respect for decisions, support for the family, and treatments to help psychological and spiritual concerns.
Ethics: A system of moral principles and rules that are used as standards for professional conduct. Many hospitals and other health care facilities have ethics committees that can help doctors, other healthcare providers, patients and family members in making difficult decisions regarding medical care.
End stage: The last phase in the course of a progressive disease. As in end-stage liver disease, end stage lung disease, end-stage renal disease, end stage cancer etc. The term "end stage” has come to replace "terminal” because somehow "end stage” seems more scientific and less despairing than "terminal”. The only "stage” past "end stage” is usually death or a reprieve from it by a transplant.
Hospice: hospice is an organization or institution that provides comfort (i.e. palliative) care for dying individuals when medical treatment is no longer expected to cure the disease or prolong life. Hospice sometimes also applies to an insurance benefit that pays the costs of comfort care usually at home for patients with a prognosis or life expectancy of six months or less.
Living Will: A type of advance directive in which an individual documents his or her wishes about future medical treatment should he or she be at the end of life and unable to communicate. It may also be called a "directive to physicians”, "healthcare declaration”, or "medical directive”. The purpose of a living will is to guide family members and doctors in deciding how aggressively to use medical treatments to delay death.
Medical Power of Attorney: A document that allows an individual to appoint someone else to make decisions about his or her medical care if he or she is unable to communicate. It may also be called a healthcare proxy, medical power of attorney or appointment of a healthcare agent. The person appointed may be called a healthcare agent, surrogate, attorney-in-fact, or proxy.
Medicaid: State programs of public assistance to persons regardless of age whose income and resources are insufficient to pay for healthcare. The United States federal government provides matching funds to the state Medicaid programs.
Medicare: The United States government's health insurance program for:
- "Senior citizens” –people 65 years of age or older.
- Certain younger people with specific disabilities, and
- People with end-stage renal disease (ESRD) – permanent kidney failure requiring dialysis or a transplant.
Metastasis: Thetransferofdiseasefrom oneorganor part to another notdirectlyconnected with it. Thecapacitytometastasizeis acharacteristicof allmalignanttumors.
Palliative Care: The World Health Organization defines palliative care as:
"…an approach that improves quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological, and spiritual.”
Key points on the WHO approach:
- The palliative approach comes early in the course of an illness, not just as end-of-life care.
- There is an emphasis on promoting holistic care to ensure physical, psychological, social, and spiritual well being.
- The family and significant others are included in the care process.
- There is an emphasis on impeccable assessment, early identification of problems, and implementation of appropriate treatments.
- Disease modifying treatments, such as chemotherapy and radiotherapy, may have a role.
- Palliative care can be provided in any setting.
- There is an emphasis on a team approach to care.
Quality of life: The term "quality of life” is used to describe a person's perception of their position in life within the culture and value systems he or she lives in, and in relation to his or her goals, expectations, standards, and concerns. It is a broad ranging concept and incorporates the person's:
- Physical health
- Psychological state
- Level of independence
- Social relationships
- Personal beliefs
- Relationship to prominent features of the environment (example: the place of care)
Radiation therapy: Radiation therapy is the use of radiation (x-rays) to treat a range of diseases including cancer. Radiation therapy can be given on its own, or it might be given with other forms of treatment such as chemotherapy or surgery. Radiation therapy is designed to destroy cancer cells while reducing the impact of radiation to healthy cells. Radiation therapy is a localized treatment, which means that it is a treatment that in general affects only the part of your body that is receiving treatment.
Respite care: Refers to care provided in the home or health care setting aimed at temporarily relieving the primary caregiver.
The above definitions are compiled from the following websites:
Biology Online. http://www.biology-online.org/
End of Life Decision Making.
Mayo Clinic. http://www.mayoclinic.com/health
U.S. Department of Health and Human Services- National Institutes of Health
World Health Organization (WHO). http://www.who.int/cancer/palliative/definition/en/