We all need palliative / supportive care at some stage in our lives (as the carer, family member, neighbour, friend or maybe as the patient!). Many of us (especially health professionals!) do not understand what palliative care is…..! Many medical colleagues still believe that giving morphine ‘towards the end…..’ is Palliative care!
Because of these professionals’ poor understanding of palliative care principles, symptomatic patients (reviewed by them) are told that they are not ready for palliative care yet..” and later, same colleagues make urgent (late) referrals to palliative care services.
In the UK, many palliative care physicians involve early stages of the ‘disease journey’ and provide good symptom relief!
In UK (few training places), they conduct combined clinics with oncology or palliative care registrars.
The “referral timing” plays a major role with their understanding of Palliative care (see the above diagram – late referrals – old concept) & create a fear factor to patients / family (“we can’t do anymore… Therefore, go to palliative care….”) and patient considers us as “terminators” or review by palliative care services as “one step prior to the grave”.
This results in poor compliance to prescribe medications / create poor trust – (supportive care needs trust & good doctor-patient relationship)
A large number of research studies showed improved quality of life with early palliative care interventions.
What is Palliative Care?
“ACTIVE TOTAL CARE” (Holistic Care) of patients whose disease is not responsive to curative treatment. Palliative care addresses physical symptoms (such as pain or nausea) as well as helping with emotional, spiritual and social needs. To achieve this, the multidisciplinary approach is paramount.
Palliative care is not to shorten or postpone death; instead, it offers a support system to enable people to live as actively as possible until their death, in the environment of their choice. Palliative service is not only for Patient…., but also for…. family & carers
*Palliative Care is recognised as a speciality in the UK in 1987, in NZ in 2001 & in Australia in 2005….!