Information for patients
Palliative care addresses all the needs of the individual concerned. The focus is on the wishes of the patients.
What is palliative care?
Palliative care covers the services offered to people with incurable illnesses, regardless of age or diagnosis, and their relatives and caregivers. These illnesses typically include:
- cancer
- cardiovascular diseases
- pulmonary diseases (COPD)
- neurological disorders (e.g. multiple sclerosis, Parkinson's)
- autoimmune diseases
Palliative care can be employed throughout the period of an incurable illness. There is no clear dividing line between when curative and palliative treatment are used. In fact, the two types of treatment can even overlap in time.
Palliative care treatments can be administered at home or on an outpatient or inpatient basis.
The word «curative» means healing. A treatment is considered to be curative if it cures an illness, whether completely or partially. Curative treatment and palliative care are not mutually exclusive, but can take place at the same time.
Palliative care is more than support and care during the final phase of life. Early palliative care starts as soon as an incurable illness is diagnosed. Particularly if the palliative care is initiated at an early stage, it can help the patients live with their illness and enable them to make their own decisions for a better quality of life.
General palliative care services are provided in an outpatient or inpatient primary care setting, where the focus is on forward planning and the alleviation of clinical symptoms.
Specialised palliative care treats and supports patients with complex symptoms and in unstable situations that require expertise in specialist areas of palliative care. Those working in general palliative care can call upon the advice and support of experts in specialised palliative care.
General and specialised palliative care differ in terms of their remits and the skills of the providers, although overlaps between the two can also exist.
Domiciliary treatment refers to the provision of services by professionals to patients in their own home. Outpatient treatment takes place in a specific facility outside the home. Inpatient treatment is provided in an institution (e.g. hospital) where the patients also stay overnight.
Expertise from various specialist areas
Professionals from various specialist areas are involved in treatments provided at home, in an outpatient or inpatient healthcare setting as required:
- Physiotherapy
- Occupational Therapy
- Dietary counselling
- Psychology
- Pastoral care
- Social welfare
The task of palliative care is to coordinate the various professionals so as to ensure optimal care.
Later – at an advanced stage of the illness when the patient's needs are increasingly complex – there are also palliative wards in acute hospitals or nursing homes, or palliative clinics.
Information on palliative care in municipal nursing centres (städtische Pflegezentren)
Care at home
One of the aims of palliative care is to enable people with incurable illnesses to live independently in their own home for as long as possible, if they so desire. Community nurses or private care services support patients and relieve the burden on their relatives by providing domiciliary treatments.
For medical emergency situations at home it is advisable to draw up a corresponding emergency plan (Notfallplan) in advance.
Advance directive, power of attorney and emergency plan
Advance directive (Patientenverfügung)
An advance directive, or living will, is a written declaration of the patient's wishes relating to medical measures. It is drawn up as a precautionary measure and takes effect when decisions can no longer be made and expressed by the patient themself. Further information and templates can be found on the website of the Swiss Medical Association (FMH).
Power of attorney (Vorsorgeauftrag)
If a patient is no longer able to give consent, a power of attorney specifies who will act as the representative of the incapacitated patient in personal, financial and legal matters. The power of attorney is also a written declaration of the patient's wishes. Please see the FAQ for more information.
Emergency plan (Notfallplan)
An emergency plan serves as a guide during medical crises. It enables foreseeable complications to be discussed with the patient and their relatives, and corresponding measures to be determined. The patient keeps the emergency plan in an emergency box together with their medicines. See Rapid assistance & emergencies.
Funding
Palliative care services are basically funded by compulsory health insurance and by cantons or local municipalities, augmented in some cases by supplementary insurance policies. However, not all costs are covered, depending on the type of services and the insurance policy in each case. Information on the responsibility for costs should be clarified at an early stage with the health insurance fund.