CFPC CAC Palliative Care key terms

Active, holistic care for people with serious illness that relieves suffering and improves quality of life for the patient and family, alongside curative or life-prolonging treatment.

A palliative approach delivered in the final phase of life, usually when curative treatment stops and prognosis is measured in months, focused on comfort and family support.

The idea that suffering has physical, psychological, social, and spiritual dimensions that interact, so relieving pain requires attention to all four, not just analgesia.

The outcomes a patient values most, agreed through conversation with the team and family, which then guide which treatments are started, continued, or stopped.

An ongoing process of reflection and discussion in which a capable person clarifies values and wishes for future care and records them for use if they lose capacity.

A written or witnessed statement made while capable that records treatment preferences or names a decision-maker, intended to guide care after capacity is lost.

The person legally entitled to make health decisions for someone who lacks capacity, chosen by the patient or assigned by law, and required to follow known wishes.

The legal and ethical standard used when a patient's wishes are unknown: decide as the patient would, weighing benefits and burdens of proposed treatment.

A documented instruction, made by a capable patient or substitute decision-maker, that CPR should not be attempted if the heart or breathing stops.

A judgement that an intervention cannot achieve its intended physiological goal or any benefit the patient would value, so it need not be offered.

Deliberately stopping an intervention such as dialysis or ventilation because it no longer serves the patient's goals, with continuing comfort care.

Deciding not to start a potentially life-prolonging intervention because burdens outweigh likely benefit; ethically equivalent to withdrawing a treatment already begun.

The expected course and likely duration of a disease for a particular patient, communicated as ranges and uncertainty to support planning and decision-making.

The characteristic pattern of decline over time in a chronic disease, such as steady cancer decline or the fluctuating failure of organ disease, used to anticipate needs.

The final period of life, often defined as days to weeks, when death is expected and care shifts to comfort, presence, and preparation of the family.

The last days or hours of life, recognized by reduced consciousness, minimal intake, changed breathing, and cool mottled skin, when interventions are minimized.

Systematic, repeated evaluation of a patient's symptoms using history and validated scales such as a numeric rating or Edmonton Symptom Assessment System score.

A brief validated tool in which patients rate nine common symptoms, including pain, fatigue, nausea, and anxiety, on 0-to-10 scales to track change.

A transient flare of pain that occurs despite otherwise adequate around-the-clock analgesia, often predictable with movement or unpredictable, needing rapid-onset rescue dosing.

Pain triggered predictably by a specific movement or activity, such as turning or walking, so it is prevented by pre-treating before the provoking action.

An extra dose of short-acting analgesic given for breakthrough or incident pain, usually about one-tenth of the total daily opioid dose, and counted when adjusting baseline.

Adjusting opioid dose stepwise against the patient's reported pain and adverse effects, adding rescue doses to the regular total when pain is uncontrolled.

Switching from one opioid to another, using equianalgesic tables and reducing the calculated dose for incomplete cross-tolerance, when analgesia is poor or toxicity occurs.

The dose of one analgesic that produces roughly the same pain relief as a stated dose of another, used as the starting point when converting between opioids.

Adverse effects of excess opioid, including sedation, myoclonus, delirium, and slowed breathing, managed by dose reduction, rotation, or supportive measures.

An opioid antagonist given to reverse dangerous respiratory depression; in palliative care it is titrated in small doses so that pain control is not abruptly lost.

A drug whose main indication is not pain but which relieves particular pain types, such as anticonvulsants for neuropathic pain or corticosteroids for bone pain.

Pain caused by damage or disease of the nervous system, described as burning, shooting, or electric, often with altered sensation, and responding partly to adjuvants.

An acute fluctuating disturbance of attention and awareness with altered cognition, common near the end of life and often triggered by drugs, infection, or organ failure.

Agitated, purposeless movement and distress in the last days of life, often reflecting delirium, pain, retention, or existential fear, managed by treating causes and sedating if needed.

Noisy breathing from secretions in the upper airway in an unconscious dying patient; it is often not distressing to the patient but is managed with repositioning and antisecretory drugs.

Deliberate, proportional reduction of consciousness with sedating drugs to relieve unbearable symptoms that other treatments cannot control, with consent where possible.

Suffering arising from loss of meaning, hope, or connection, or from conflict with beliefs, expressed as anguish, guilt, or withdrawal and addressed through respectful presence and referral.

Care offered to family and carers before and after death, from routine information and follow-up to targeted counselling for those at high risk of complicated grief.

The respectful care of the body after death, including positioning, washing, and attending to cultural or religious requests, while supporting the family present.

Visible motor restlessness or distress that may reflect unrelieved pain, delirium, breathlessness, or fear, and which is assessed before any sedating drug is given.

Using brief validated questions and clinical interview to distinguish persistent low mood and anhedonia from the fatigue and sadness expected with advancing illness.

A strong opioid used as the reference analgesic in palliative care, given orally or parenterally, with constipation and nausea anticipated and prevented.

A group of physicians, nurses, pharmacists, social workers, and spiritual care providers who share goals and coordinate care with the patient and family.