Palliative care is a concept too often relegated to the back burner in discussions of medical care needs because it's associated with death. It means providing comfort to the terminally ill, not a cure.

Anyone who has watched a loved one endure a painful end to a terminal illness, however, knows all too clearly that relieving patient pain and enhancing comfort is life-affirming. It improves the quality of that person's remaining time on Earth, days that can extend to weeks or even months.

That's why a recent report, giving Hawai'i only a "C" grade for providing palliative care, is a call to action.

The first step would be improving the reach of end-of-life services to people through hospital-based medics.

The report, issued by the Center to Advance Palliative Care, includes the all-too-short hospital roster: Hilo Medical Center, Kaiser Permanente Medical Center, The Queen's Medical Center, Hawaii Medical Center East, Straub Clinic and Hospital, Tripler Army Medical Center, Hawai'i State Hospital and Moloka'i General Hospital. This leaves out Kaua'i and Maui hospitals entirely.

The next step is to add outreach programs, making these services more accessible to patients at home. Being allowed to spend precious days in the most familiar and comfortable surroundings is the essence of humane treatment.

For the patient, for their family caregivers who need support so that they can make the most of limited time, it makes a world of difference.