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Introduction of Palliative Care

Dr Nahid Afsar

MD PalliativeMedicine(PhaseB)

BSMMU

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  • In her book OPTIMISM (1903), American author Helen Keller expressed-

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“Although the world is full of suffering, It is also full of the overcoming of it”

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  • The word ‘palliative’ is derived from the Latin�word ‘pallium’ meaning ‘a cloak’.

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  • In palliative care, symptoms are ‘cloaked’ with�treatments whose primary aim is to promote comfort. �

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What is Palliative care

  • Palliative care is the active total care of patients with an incurable progressive life threatening condition, and their families, by a multi professional team.

  • According to WHO, “Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual”.( WHO 20002)

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Palliative Care:

  • Provides relief from pain and other distressing symptoms
  • Affirms life and regards dying as a normal process
  • Intends neither to hasten nor postpone death
  • Integrates the psychological and spiritual aspects of patient care
  • Offers a support system to help patients live as actively as possible until death
  • Offers a support system to help the family cope during the patient’s illness and in their own bereavement
  • Enhances quality of life and positively influence the course of illness ��

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Supportive Care

  • The emphasis of supportive care is to support patients and families ‘during treatment and allowing them to live as well as possible with the effects of the disease’ (NICE, 2004 p.18) and even mentions from diagnosis through to cure as well as to death and bereavement.

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End of Life Care

  • End of Life Care Strategy (2008) has the aim of allowing patients to ‘live as well until they die throughout the last phase of life and into bereavement’.
  • The last phase considered to be last 12 months of life.
  • Advanced Care Planning
  • Amber Bundles

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It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease.

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Total Pain Dimensions:

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Quality of Life:

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  • ‘Quality of life is what a person says it is.’

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  • Palliative care is about quality of life, and includes rehabilitation. It seeks to help patients achieve and maintain their maximum potential physically, psychologically, socially and spiritually.

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Quality of Life:

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Why Palliative Care is needed:

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  • In 2017, The Lancet Commission Report estimated that over 60 million people, among whom 5.3 million are children, require palliative care each year throughout the trajectory of a medical condition.

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Need by Disease Groups:

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Need for Palliative Care in Bangladesh:

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UUncontrolled

Complex

Symptoms

Psychological

Emotional

Issues

Related to illness

Complex Social Issues

Psychospiritual

Issues

REFERRAL CRITERIA

End of Life care

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Who are the palliative care patients

  •  Patients Terminally ill
  • Patients with distressing symptoms
  • Patients Bedridden with Chronic illnesses
  • Elderly Patients Bedridden with debility of age and multiple co-morbidities
  • Patients suffering from inborn error metabolism
  • Life limiting Pediatric patients( No cure from the disease, Cerebral Pulsy)

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Common example

  • Patient suffering from malignancy
  • End Stage COPD
  • End Stage Renal failure
  • End Stage Heart failure
  • Terminal Stage Stroke
  • Motor Neuron Disease
  • Dementia
  • Congenital Anomalies

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We can not cure the patient but we can care the patient

https://doi.org/10.1111/bjh.18286