Palliative care refers to specialized medical care offered to people living with severe
health conditions. According to the World Health Organization (WHO), palliative care is a mix
of activities that helps improve the quality of life of patients with life-threatening health
conditions (WHO, n.d). Individuals with terminal illnesses live with a lot of pain and distress.
It therefore, ensure that the level of pain and suffering is reduced to
bearable levels. Burke et al. (2019) noted that some of the terminal health conditions that require
palliative care include cancer, congestive heart failure (CHF), Amyotrophic Lateral Sclerosis
(ALS), kidney disease, and chronic obstructive pulmonary disease (COPD). It is a
common practice in primary health facilities provided by trained doctors, nurses, and other
specialists who work to provide support to patients. The care is offered to relive pain and
suffering using early identification and treatment. This paper aims to discuss the origin,
principles, and delivery of palliative type of care.
Origin, history, and development
Palliative type of care began as hospice care that is provided by caregivers at health facilities
owned and operated by religious groups. The primary goal of hospice care is to improve patients
and their families’ quality of life. The practice was founded by Dame Cicely Saunders, a British
physician in the year 1948, to provide care services that alleviate pain and suffering for patients
with terminal illnesses (Murray et al., 2017). Cicely Saunders, the founder of St Christopher’s
Hospice in London, was born on June 22, 1918, at Barnet in the United Kingdom. During her
service as a nurse, Saunders met David Tasma- a Polish Jew young man dying of cancer, and this
inspired her to devote her life to care for the dying. Saunders believed passionately that the last
days of a person could be made dignified and happy through care (Murray et al., 2017). She spent most of her time listening to patient’s stories of illness and suffering from which she helped
alleviate physical, emotional, social, and spiritual pain. Saunders’ success in improving the
patient’s quality of life prompted her to introduce the practice to other physicians. Cicely
Saunders built a strong philosophy around the belief that although death is natural, it should be
free from suffering and pain (Murray et al., 2017).

The specialty of palliative type of care was introduced in the United Kingdom in 1987 (Stevens
& Milligan, 2019). It was around the same time that the practice was expanded to other patients
with life-limited diseases. Today, Cicely Saunders is remembered for founding the hospice care
and building a hospital to serve the dying by relieving their physical and emotional suffering
(Clark, 2018). She also authored books on terminal care, including Care of the Dying and
Beyond all Pain. The contribution of Elisabeth Kübler-Ross in the field of palliative care is also
notable. Elisabeth Kübler-Ross is said to have been the first individual to transform how the
world looks at the terminally ill (Dugan, 2019). Kübler-Ross pioneered hospice care as well as
near-death research. She is recognized to have brought the lives of individuals with terminal
illnesses to the public eye. Elisabeth Kübler-Ross also wrote over 20 books on the subject of
death and dying.
After its opening in 1967, St Christopher quickly became an inspiring model for others.
Larson (2017) posits that the success of palliative care at St Christopher’s health facility was
fueled by a combination of approaches such as excellent clinical care, research, and education.
The practice established itself as an approach that can meet the complex needs of individuals
with terminus illnesses (Larson, 2017). For this reason, palliative care grew from an activity only
practiced by religious communities to one that is part of nurse and medical training. As of today,
palliative care is present in both affluent countries and developing countries.

WHO Principles of this type of care
The WHO has developed nine principles of palliative type of care. The first WHO principle is the provision of services that help relieve pain and other distressing symptoms
(WHO, n.d, para 2). It is committed to providing services that relieve physical,
social, psychological, spiritual, and social suffering. The palliative type of care also provides a solution
for other distressing symptoms such as lack of energy, cough, and nausea. The second WHO
principle states that it affirms life and is in agreement with the fact that death as a
natural process (WHO, n.d, para 2). This means that it does not oppose the existence
of death to patients in the UK but ensures that individuals with terminus illnesses spend their last
days devoid of pain and suffering. The third WHO principle states that palliative type of care offers all
manner of support needed by patients to live a happy life before death (WHO, n.d, para 2)
Interestingly, palliative type of care in the UK offers support not only to patients with life-threatening
illnesses but also to their families and caregivers to help them manage with the patient’s illness
and in bereavement.
The fourth WHO principle states that palliative type of care neither hasten death nor postpone
death (WHO, n.d, para 2). In other words, the aim of palliative care is to provide a greater level
of patients’ comfort as well as improve the quality of life. The fifth WHO principle states that
palliative care ensures that patients receive a mix of psychological and spiritual care (WHO, n.d,
para 2). Nurses providing palliative type of care spend time listening to their patients and then respond
by giving spiritual support. The phycological and spiritual care goes hand in hand in palliative
care.
The sixth WHO principle states that this type of care offers support to patients with
life–threatening illnesses to help them live as actively as possible in their last days (WHO, n.d, para 2). The nurses who provide palliative type of care help patients to do physical exercises such as
walking, cycling, and swimming. The seventh WHO principle states that palliative type of care uses a
multidisciplinary team approach to satisfactorily address the needs of patients together with their
families (WHO, n.d, para 2). Different health professionals are readily available in the UK to
provide the needs of patients. The eighth WHO principle states that palliative type of care may enhance
patients’ quality of life as well as positively influence the course if the terminal illness. This
means that individuals receiving palliative care may heal or live longer than they would have
otherwise lived. The ninth WHO principle states that if palliative care is offered early enough
coupled with other therapies, it can help manage complications (WHO, n.d, para 2).
The different palliative care organizations established in different countries include; the
American Board of Hospice and Palliative Medicine (ABHPM), American Academy of Hospice
and Palliative Medicine (AAHPM), Committee of Rehabilitation and Palliative Care of China
Anti-cancer Association (CRPC), and the Kenya Hospices and Palliative Care Association
(KEHPCA) among others (Centeno et al., 2016). All the organizations in different countries,
together with the World Health Organization, promote all the six principles of the care
discussed above.
Delivery of this type of care
Tanuseputro et al. (2017) observed that this type of care is provided by different health
professionals, such as doctors, nurses, pharmacists, and physical therapists. In the
UK today, this care is offered in different environments such as hospitals, nursing homes, at home,
specialized clinics, or outpatient palliative care clinics (Tanuseputro et al., 2017). Receiving
palliative services in different settings in the United Kingdom may have advantages as well as
disadvantages. The benefits of receiving care at home are that patients feel more comfortable and at peace because the environment is friendly (Sternberg, 2017). However, receiving care at home
may be challenging because patients may be forced to attend to house demands (Sternberg, 2017,
p.968). Similarly, receiving care in a nursing home has benefits such as improved outcomes and
fewer symptoms. Receiving care from a nursing home, however, may be expensive and less
convenient (Temkin-Greener et al., 2018, p.13).
In summary, palliative care is an approach to alleviate pain and suffering to individuals
with terminus health conditions. It began as hospice care back in 1948. Dame Cicely
Saunders founded it. Saunders built the first hospital for patients with terminal
illnesses- St Christopher in 19967. Saunders is also known for devoting her life to research about
care for the dying. Elisabeth Kübler-Ross is also a pioneer of palliative type of care as she became the
first individual to transform the way the world looks at the terminally ill. Elisabeth Kübler-Ross
also authored more than 200 books about death and dying. The nine WHO principles of
this type of care are promoted by different  organizations in countries across the
world. In the UK, this care is today offered by various health professionals, such as
doctors, nurses, and physical therapists. Receiving treatment from home is regarded as
convenient although, patients may engage in home activities rendering palliative care services
ineffective.

The paper should be in APA 6th edition