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What’s Palliative Care?
Awareness on Palliative Care
By Dr. Priyadarshani Godigamuwa
What is palliative care?
Palliative care is an interdisciplinary medical care-giving approach that improves quality of lives of patients and their families facing the challenges associated with life threatening illness, through the prevention and relief of suffering by means of early identification, impeccable assessment and treatment of pain, illnesses and other difficulties whether physical, psychological or spiritual.
Palliative care aims to help patients live their lives as fully and as comfortably as possible when living with a life limiting or terminal illness.
It involves identifying and treating symptoms which may be physical, emotional, spiritual or social, in order to provide holistic and personalized care and is a step away from generalized patient care. It was previously the case that palliative care was provided at the end of life, and often associated with the idea that death is nearing. However, a new model of care moves away from this and stresses the importance that palliative care can be helpful at any stage of illness. Concept of “good death“ is also a big part of palliative care.
What’s good death?
Patients should have some understanding when death is coming and what can be expected. He or she should be able to have control over pain and other symptoms.
The patient’s dignity and privacy should be respected while maintaining the spiritual and emotional stability. He or she should get necessary information and expertise.
Patients get their own choice and control over where death occurs, who is present, who shares the end and most importantly, should have time to say goodbye and have control over other aspects of timing.
Make sure patients know their wishes are respected. Ultimately, prepare patients, to be able to leave when it is time to go.
What are the illnesses needing palliative care?
Palliative care can be accessed by anyone with a life limiting illness:
- Incurable cancers
- Organ Failure – Heart, lungs or liver failure.
- Frailty – dementia, Alzheimer’s, Parkinson’s disease etc.
- Any other chronic life limiting medical condition needing frequent attention.
When to start palliative care?
We used an older model in the past, where the palliation started when the patient became terminally ill.
In the new model, palliative care starts when the life limiting illness is diagnosed and runs in parallel with active medical management. Palliative care should be offered and be available from the time of diagnosis until it’s no longer needed – at any stage and in any care setting.
What are the benefits of having palliative care?
There are a number of benefits to the patient and family by receiving proper palliative care:
- Provides relief from pain and other distressing symptoms
- Affirms life and regards life as a normal process
- Advanced care plans – addressing psychological and spiritual needs
- Communication with patient, family and multidisciplinary team
- Offering support system to families during the illness and after
- Discharge planning
- Care coordination
- Terminal care
- Bereavement care – team approach to the patient and family bereavement counseling if needed.
Why palliative care is important in cancer care?
For cancer patients, it’s important to remember that the effects of cancer and its treatment can be very different from person to person. A palliative care team includes a team of health staff who look at each person’s situation and works together to help the patient and caregiver with various types of needs.
The palliative care team can help by:
- Controlling physical symptoms and side effects
- Managing emotions that come with a cancer diagnosis and treatment
- Showing the family ways of coping with life and the new situation change following illness of the family member
- Understanding any spiritual concerns
- Supporting needs of caregivers
- Assisting with financial and social issues
- Transitioning to hospice care if treatment stops working or if cancer worsens.
Are benefits of palliative care scientifically proven?
There are many studies that shows the benefits of palliative care on the well-being of patients and their families or caregivers. For example, studies have shown that patients who have palliative care visits while in the hospital spend less time in intensive care units and are less likely to visit the emergency room or be re-admitted to the hospital after they go home.
Studies have also shown that people with chronic illnesses, like cancer, who get palliative care, have less severe symptoms. These patients have better quality of life, less pain, less shortness of breath, less depression, and less nausea.
Research has also shown that cancer patients receiving palliative care have better emotional health. Their families also feel more satisfied with the patient’s care.
Some studies have also suggested that starting palliative care soon after a cancer diagnosis may also extend survival.
Is there a difference in palliative care and hospice care?
Yes, palliative care starts at the beginning of an incurable condition. Hospice care provides at the latter stages of life i.e when the patient’s lifespan is expected to be below 6 months. Hospice care is also a part of palliative care.
Is our Sri Lankan society matured enough to support palliative care?
In Sri Lanka, the concept of familial structure is usually very strong and consequently the involvement of family in the care of patients is the norm. However, the basic knowledge about palliation is still not widespread enough among Sri Lankan population and the concept of good death is not practiced by most families. Seeking professional palliative care will address this problem.
Where can we get palliative care in Sri Lanka?
National cancer Institute Maharagama (Apeksha Hoapital) has a well established palliative care unit. Teaching Hospital Karapitiya and Teaching Hospital Kandy too have palliative care units.
All cancer units in each district in Sri Lanka provide palliative care. Patients should inquire from the health staff in the treating hospital.
What is the role of society in palliative care?
Society should be educated about palliation. Palliative care mainly depends on a multidisciplinary medical team. When it comes to patient care, society can provide a huge support to patients and their families in providing physical, emotional, and financial assistance.
