The problem of pain and the quality of life

In industrialised countries, the prolonging of life span and the cronicization of acute pathologies are producing a large number of patients affected by incurable illnesses, which, in the final phase, bring about prolonged of serious and continuous suffering and produce physical and psychological symptoms which extend to the social and spiritual spheres.

For these patients, improving the quality of life is the only possible objective.

The specific medical answer for the needs of the incurably ill is the approach known as Palliative Care, whose aim is to help the terminally ill, intervening simultaneously on all fronts: physical, psycho-cognitive, social and spiritual.

Palliative care is the active, global and multi-disciplinary care of patients affected by illnesses which no longer respond to specific treatments, and of which death is the direct outcome.

The control of pain of other symptoms and of the psychological, social and spiritual problems is of paramount importance. The aim of palliative care is to improve the quality of life of patients and their families.

Palliative care acknowledges death as a natural process which cannot be neither hastened nor impeded. Since this suffering is also shared by the family, they too must be helped, both in assisting the patient and during the period of mourning.


The History

Palliative Care has its origins in the "Hospice movement".

Our Lady's Hospice of Dublin was founded by Mary Aikenhead in 1846 and it was dedicated to the care of the dying. Very soon hospices spread to England (Hostel of God, St. Luke's Hospice, St. Joseph Hospice). Similar initiatives were started in France and USA (Calvary Hospital in New York). In the early 1950s the Marie Curie Memorial Foundation began to organise in U.K. home nursing assistance and inpatients facilities (the Marie Curie Homes). Since then, in Great Britain, hospices have grown both in number and quality, thanks specially to the work of Dame Cicely Saunders with the foundation in Sydenham of the St. Christopher Hospice, the father of modern hospices.

In 1974, the Connecticut Hospice and in New York, the St. Luke's Hospital, began to provide home care. 
In 1988, The European Association for Palliative Care (EAPC) was founded. 

Today, programmes for palliative care and hospices are present in over 70 countries, many of which have fully accepted palliative care as part of the National Health Service. In several countries, specialization in Palliative Medicine has been introduced.


The situation in Italy

Italy was one of the first among those in Europe to move along these lines. As early as the beginning of the 1980s, with the help and financial support of the Floriani Foundation of Milan, the first "UnitÓ di Cure Palliative" was started up at the National Cancer Institute of Milan, followed by one in Cremona and in many other cities. 

Their work, essentially home-based, served as a model for many other similar initiatives, inspiring the creation of units of palliative care both inside and outside the public structure in many regions of Italy.

In the 1980s, the Italian Society of Palliative Care (SICP) was founded, which today boasts over 1600 members, and also the Italian School of Palliative Medicine (SIMPA), which has trained hundreds of doctors and nurses.


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