((Cure)Cure)((Prolong life)Prolong life)((Improve the Improve the quality of life)quality of life)

To cure sometimeTo cure sometimeTo relieve oftenTo relieve oftenTo comfort alwaysTo comfort always

FabiolaFabiolaHospiceHospiceSt. Vincent de PaulSt. Vincent de Paul((Sisters of Charity)Sisters of Charity)((Irish Sisters of Irish Sisters of Charity)Charity)((St. JosephSt. Josephs Hospice)s Hospice)

((Dame Cicely Saunders)Dame Cicely Saunders)19671967((St. St. ChristopherChristophers Hospice)s Hospice)((Hospice care)Hospice care)((Palliative medicine)Palliative medicine)((Hospice Hospice care)care)((Palliative Care)Palliative Care)

Dame Cicely Saunders Dame Cicely Saunders

((Total Total Pain Care)Pain Care)

((Care in their community)Care in their community), , , , ((Continuity in care)Continuity in care)

Definition of Palliative Care by Definition of Palliative Care by WHO,1990WHO,1990

--

19701970s s 829829

1982 1982 ,,1990 1990 1991 1991 1993 1993

1994 1994

--

1995 1995 1996 1996 (())1997 1997 (())(() ) 1998 1998 1999 1999

--

2000 2000 [[]], , (())(())

2001 2001 2002 2002

2003 2003

1995 1995

1996 **1996 **

****

****

****6060

2000 2000

2000 2000 ( 2000/7 )( 2000/7 )

2000/5/23 2000/5/23 DNRDNR

2002/11/22 2002/11/22

1990, WHO

--Holistic CareHolistic Care --Family CareFamily Care --Team CareTeam Care

-- Continuing CareContinuing Care

(1)(1) ((Hospice Hospice

InIn--patient care) patient care)

Acute & chronicAcute & chronic

(2)(2) ((Hospice home care)Hospice home care)

(3)(3) ((Hospice day care)Hospice day care)

(1)(1)

(2)(2)

(3)(3)

(4)(4)((Uncertainty)Uncertainty)

() ()

1.1.2.2.3.3.4.4.5.5.6.6.7.7.8.8.9.9.10.10.

89.789.785.585.579.979.967.867.856.656.650.050.048.148.144.044.036.936.936.936.9

11.11.12.12.13.13.14.14.15.15.16.16.17.17.18.18.19.19.20.20.

34.134.132.232.231.831.831.331.330.430.422.922.922.522.519.119.118.318.316.416.4

((Total Pain) Total Pain)

Total Pain

Dame Cicely Saunders --- (Total Pain)