Two definitions

The following are two definitions of palliative care.

Palliative care for children and young people with life-limiting conditions is an active and total approach to care, from the point of diagnosis or recognition, embracing physical, emotional, social and spiritual elements through to death and beyond. It focuses on enhancement of quality of life for the child/young person and support for the family and includes the management of distressing symptoms, provision of short breaks and care through death and bereavement. The Association for Children’s Palliative Care (ACT)

Palliative Care is comprehensive, specialized care provided by an interdisciplinary team to patients and families living with a life-threatening or severe advanced illness expected to progress toward dying and where care is particularly focused on alleviating suffering and promoting quality of life. Major concerns are pain and symptom management, information sharing and advance care planning, psychosocial and spiritual support, and coordination of care. The American Academy of Hospice and Palliative Medicine

Do they say the same thing? No, not at all. The first definition bases the need for services on the disease only (from the point of diagnosis or recognition...through to death and beyond). While the second definition bases the need for services on the progression of the disease (life-threatening or severe advanced illness) which is subjective and allows medical professionals to put off the discussion. This further reinforces the perception that palliative care is about death and not about enhancing life. Furthermore the second definition does not account for services the family will need subsequent to the death of the patient.

In my opinion the differences between these definitions are a key factor in helping us understand why palliative care services in the UK are at least 20 years ahead of those in the US.