Many hospices provide care for any patient with advanced incurable disease

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7066.1210c (Published 09 November 1996) Cite this as: BMJ 1996;313:1210
  1. Stephen M W Hutchison
  1. Consultant physician in palliative medicine Highland Hospice, Inverness IV3 5SB

    EDITOR,—Anne Mary Jayes rejects the idea that palliative care should be available only to people who are dying.1 I agree with her. The principles of palliative care should be available to any patient with any illness, and palliation is often the only treatment available for common chronic diseases.

    As in many other such units, Highland Hospice's criteria for acceptance extend to anybody with advanced incurable disease. Patients with malignancy are commonly admitted for control of their symptoms. We pursue an active treatment and rehabilitation policy and discharge over half of our inpatients. Thus even patients with terminal illness do not have to be dying, or even in a terminal phase, to merit admission.

    We have been offering planned inpatient and outpatient respite care for patients with severe Parkinson's disease. We are restricted, however, in what we can routinely offer to patients with non-malignant conditions and indeterminate prognoses and have to approach this issue carefully. We could easily be overwhelmed by requests for respite or even long term care, which would seriously compromise our service. Most hospices could offer respite care to only a tiny proportion of patients with chronic nonmalignant disease.

    Care for carers is available in the community and offers some respite, but, without a considerable expansion of resources, hospices cannot realistically meet the need for inpatient care. We depend on other providers for this, particularly when long term care is required.


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