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Author: Vilma A. Tripodoro, Dra en Medicina Paliativa e Investigadora Senior, Universidad de Navarra
Original article: https://theconversation.com/palliative-and-hospice-care-why-society-cannot-ignore-the-needs-of-terminally-ill-patients-and-their-loved-ones-241296
In general, death is a taboo subject. Nobody teaches us how to look after a dying person, and we also ignore or overlook the fact that caring for someone at the end of their life gives us a chance to reflect on the limits of our own existence.
When a patient is facing a serious illness, fear and a sense of abandonment can often make them feel profoundly cut off from the rest of the world. For this reason, it is crucial that they have people around them who are willing and able to look after them. We all know that one day it could be us, or a loved one, who needs to be eased through their suffering.
This is where palliative care comes in, a field that supplements curative medicine with care and support.
12 October marked World Hospice and Palliative Care Day, which invited us to reflect on the on this field’s significance, and on the advances made since the World Health Assembly passed resolution 67.19 in 2014, which urged countries to include it in their health services.
A holistic and multidisciplinary approach
Palliative care improves quality of life for patients and families dealing with chronic or terminal illnesses by relieving pain and other physical symptoms, as well as providing psychological, social and even spiritual support. It can be provided at any stage of illness and in conjunction with curative treatments, helping patients to live actively until the end.
Collaboration between the family and the palliative care team ensures that all the needs of the sick person – be they physical, social, emotional and spiritual – are met. It also addresses the needs of those close to the patient – bereavement support begins even before the loss, helping family members to cope with grief.
This holistic and interdisciplinary approach is essential to alleviating suffering, and providing a feeling of safety and trust.
10 years of progress, but still a long way to go
In 2014, the World Health Organisation highlighted the need to include palliative care in health policies and to improve access to essential medicines such as morphine. It also stressed the importance of training health professionals in palliative care and promoting research to improve the quality of services.
In the ten years since, major progress has been made, although significant challenges remain. In many countries, awareness of pain care has increased and training programmes have been developed, improving the quality of care. Access to basic pain relief drugs has also been made easier.
However, globally, only 14% of people in need of palliative care receive it, with very pronounced inequalities in low and middle income countries.
Restrictive regulation of morphine and other medicines remains an obstacle, and lack of both financial and human resources limits many countries’ ability to provide quality services.
How can palliative care be improved around the world?
Governments need to develop national policies and strategies that integrate palliative care into their health systems, creating legal frameworks that facilitate access at all levels. Training of health professionals, both through ongoing education and in medical and nursing degrees, is also essential.
Ensuring access to medicines such as morphine is crucial, and restrictive regulations need to be reviewed and modified. In addition to physical symptom management, palliative care needs to include psychosocial and spiritual support for both patients and families.
Lastly, it is also vital to raise public awareness through advocacy and education campaigns. Implementing all these steps will ensure accessible and quality palliative care.
How can you and I help?
As much of the world’s population ages and the burden of non-communicable diseases increases, the need for palliative care will continue to grow.
To meet this need, we have to build community networks that are aware of the value of care, and that collaborate with local organisations and train volunteers to provide accompaniment for those in need of palliative care. This will help to create caring and compassionate communities that improve the quality of life for patients and their families.
In addition to laws and government decisions, numerous initiatives have emerged to address this need. For instance, Pallium Latin America promotes training in palliative care and supports health professionals in their work throughout the region. Initiatives such as Pallium Canada and the Pallium Project in Spain train non-specialists to integrate palliative care into health systems, enabling quicker and more comprehensive access.
Other organisations, such as Pallium India and the New Health Foundation in Spain, mobilise communities to provide care and support for people with advanced or chronic diseases.
While considerable progress has been made, many challenges still remain. Three out of four people will require access to palliative care during their lifetime, meaning palliative care is, quite literally, everyone’s business.