Clinical Care Guidelines

for Adults and Adolescents Living with HIV in Ontario, Canada
View the guidelines

7. Well Being, Quality of Life, End of Life

General Recommendations

Happiness and relationships

    Palliative care and end of life care

    Palliative care is a holistic approach to care that aims to relieve suffering and improve the quality of living for patients with life-limiting diseases and their families, as well as for people at all stages of frailty or chronic illness. It strives to address the person’s and family’s physical, psychological, social, spiritual and practical issues throughout the disease trajectory or the process of aging. Palliative care involves physicians, pharmacists, nurses, psychologists, social workers, physical therapists, and complementary medicine together with primary or specialty care for patients. It includes careful assessment, early identification of any issues, treatment of pain and other problems.

    Although HIV clinical care has significantly improved health outcomes, people with HIV continue to die from illnesses common during the pre-cART era or are diagnosed and linked to care late in infection.236237 Palliative care should be an essential component of care throughout the course of HIV disease, from asymptomatic stages to the end of life. Palliative care focuses on meeting the person’s and family’s full range of needs, and it reinforces the person’s autonomy and right to be actively involved in his or her own care. Its focus on providing support and relieving symptoms can benefit people dealing with many aspects of serious HIV disease including consequences of addictions, traumas, co-morbidities, homelessness, aging or causes of death (either AIDS related opportunistic infections or so-called non-AIDS defining diseases). The following figure illustrates the integrated approach to palliative and end of life care in the home, hospital, hospice or care residence.