The purpose of palliative care

There is more to palliative care than most people understand.

What is palliative care?

Palliative care is holistic and multidisciplinary. It is a specialised approach to medical care. Although it is mostly relied upon near the end of a patient’s life, there are other situations during which it can prove helpful. In some cases, palliative care facilities are built and offered as a relief option for full time caregivers.

Palliative care works well with other treatment plans and aims to cater for a wide range of needs and preferences. This includes the provision of support for families enduring one member’s terminal or life-limiting illness.

Who needs it?

• Patients nearing the end of their lives, as a result of a terminal illness or condition.
• Severely impaired individuals, unable to care for themselves without assistance.
• A patient who is undergoing treatment for a severe disease, including Cancer.
• Someone battling a short-term illness, in need of additional care while undergoing treatment.
• Elderly patients who need additional care.

What is the purpose of palliative care?

Palliative care is purely devoted to improving your quality of life, through an illness or severe ailment. Its holistic approach covers:

• Pain management and relief.
• Symptom management (relief from associated symptoms).
• Protecting comfort and human dignity, especially related to degenerative conditions.
• Spiritual and therapeutic respect.
• Inclusion of family in important decision-making processes, and access to you as a patient.
• Maintaining your control over decisions affecting your health and treatment.
• Working in harmony with other medical and treatment providers to provide the best outcomes for patients.
• Nursing and other practical support to avoid dependence on expensive emergency services.

Why do I need a palliative care plan?

You may not neeed one today, but in ten years from now, you might be grateful you planned ahead. Accommodate for a variety of scenarios, considering that palliative care applies to many life-defining conditions. Post-retirement and senior care plans are also worth considering. Take time to put these in place to enable your loved ones to follow and respect your decisions, no matter what happens. If something affects your ability to communicate, this type of planning basically still considers your wishes.

What must I include in my palliative care plan?

• Clearly define what kinds of pain management you would like in specific scenarios.
• Spiritual, religious and personal requirements.
• Draft a Living Will. If you advance to a stage of illness and can no longer communicate, this document can be referred to on your behalf. Your care team will use your Living Will to follow your wishes and respect what you want as much as possible.
• Emergency response details. e.g. Should CPR/resuscitation be performed, or life support switched off?
• All details of any existing or historic physical conditions, and details of doctors who have treated you previously.
• You can include your estate, but your Last Will and Testament should cover this in full.

Where does it all happen?

Palliative care can be home- or hospital-based, or provided through specialised facilities. Your doctor, nurse or clinic sister can refer you to nearby providers. Remember that your body is also completely unique, and your symptoms are not the same as someone next to you. Your care plan can be defined by a number of factors:

• What conditions you have,
• How long you need palliative care for.
• Emotional, and spiritual or religious preferences.

What is respite care?

Respite care offers your family members a short break if you’re completely dependent on them for daily survival. It can be run over just a few hours to a couple of days, and helps bring balance into your home. Giving your primary caregivers and family a break, respite care is a good idea to plan for. It’s always worthwhile planning for such situations, both from a care provider and a patient perspective.

What’s the difference between palliative care and hospice care?

Hospice care is fully focused on end-of-life processes, and making these as painless as possible for patients. It won’t consider management of illnesses, or treating any condition for the goal of a patient’s recovery. Often, patients rely on a hospice when there is little to no chance of surviving beyond another six months.

Palliative care, being all-encompassing, can be relied upon at any point in a patient’s life. Some hospices do cover this type of care plan, but it’s critical to speak to the senior caregivers to know which option you are being placed on from day one.

Where in South Africa can I find palliative care providers?

• Hospitals and medical centres.
• Specialised facilities and selected hospices.
• Nursing organisations and associations.
• Home-based care organisations and associations.
• Community care associations and facilities.

The costs associated with using palliative care service providers are usually defined by:

• Your income and range of affordability.
• Your medical cover, including insurance and medical aid.

Improving global access to palliative care

Access in South Africa is relatively easy, but this is not the case in other countries. The World Health Organisation found that only 14% of people who need palliative care have access, globally. Budget cuts from governments have placed immense pressure on the medical supply chain and employment capacity for caregivers. Effective budget management and prioritisation would drastically help to improve global access to palliative care.

Sources:

Australian Medical Association. 2015. Palliative approach in residential aged care – 2015. 24 March. Available at: https://ama.com.au/position-statement/palliative-approach-residential-aged-care-2015 [Accessed 13 August 2019].

Dudbridge, L. 2016. The importance of palliative care for patients and caregivers: news from the 2016 palliative care in oncology symposium. Cancer.net. 6 September. Available at: https://www.cancer.net/blog/2016-09/importance-palliative-care-patients-and-caregivers-news-2016-palliative-care-oncology-symposium [Accessed 13 August 2019].

Get Palliative Care. 2019. What Is Palliative Care?. Available at: https://getpalliativecare.org/whatis/ [Accessed 13 August 2019].

Healthcare Improvement Scotland. 2019. Make an anticipatory care plan. NHS inform. 9 July. Available at: https://www.nhsinform.scot/care-support-and-rights/palliative-care/planning-for-the-future/make-an-anticipatory-care-plan [Accessed 13 August 2019].

Marie Curie. 2018. What are palliative care and end of life care?. 1 December. Available at: https://www.mariecurie.org.uk/help/support/diagnosed/recent-diagnosis/palliative-care-end-of-life-care [Accessed 13 August 2019].

Victoria State Government. 2017. End of life and palliative care explained. BetterHealth. Available at: https://www.betterhealth.vic.gov.au/health/servicesandsupport/end-of-life-and-palliative-care-explained [Accessed 13 August 2019].

Wayne, M, White, M, and Robinson, L. 2019. Respite Care. HelpGuide. Available at: https://www.helpguide.org/articles/caregiving/respite-care.htm/ [Accessed 13 August 2019].

World Health Organisation. 2018. Palliative care. 19 February. Available at: https://www.who.int/news-room/fact-sheets/detail/palliative-care [Accessed 13 August 2019].

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