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05 May 2009

More about palliative care

Which criteria do you have to meet to be eligible for palliative care and what does it entail?

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Where do you go?
Palliative care may be offered by a variety of institutions, including hospitals, hospices, nursing homes, long-term care facilities as well as in the home. You can speak to the hospice directly and find out which services are available in your area. Remember that different hospices service different areas.

What does it entail?
Palliative care usually involves a multi-disciplinary team that works closely with the patient to establish a plan that takes into account treatment options, pain management, emotional and social challenges as well as spiritual needs.

  • Medical staff
  • Nursing staff
  • Social worker
  • Physiotherapist
  • Occupational therapist
  • Dietician
  • Psychologist
  • General practitioner
  • Oncologist/Surgeon
  • Family members
  • Volunteers
  • The patient

Palliative care assumes a holistic approach – taking into consideration the individual's mind, body and spiritual concerns. The approach is not limited to the patient and may involve family and loved ones.

“One of the huge differences between palliative and curative medicine is that in curative medicine, the doctor is the head of the team, but in palliative medicine, the patient is the head of the team. Education of the patient and knowledge of the illness is therefore absolutely vital. We, in palliative medicine, say that we do care ‘with’ the patient and not ‘for’ the patient,” says Elizabeth Scrimgeour, Executive Officer of the Drakenstein Palliative Hospice and Chairperson of the Western Cape Hospice Palliative Care Association.

Scrimgeour says many patients don’t understand how their illness works and why they need to follow certain protocols. “Palliative care not only focuses on an expectation of dying, but now also very much focuses on an expectation of living.” For instance, she says, tuberculosis patients may fear if they take their medication and get better, their grants might be taken away.

Who is eligible?

Palliative care is most suitable to patients with serious or long-term illnesses. These may include cancer, Alzheimer’s disease, cardiac disease, multiple sclerosis and Aids. The patient can get palliative care as well as curative treatment at the same time and does not have to choose between the two.

Elizabeth Scrimgeour, Executive Officer of the Drakenstein Palliative Hospice and Chairperson of the Western Cape Hospice Palliative Care Association, says the basic criteria used at hospice is that the patient is suffering from a life-threatening and life-limiting illness and is symptomatic.

Dr Teresa Swart, part-time lecturer in palliative care at Stellenbosch University, who is currently completing her masters degree in palliative medicine, says the idea is to start palliative care very early in the disease progression.

“Previously, it was thought that you should only contact the hospice when you are really terminal, for instance, in the last two weeks of your life, but that is not ideal. We would like to get involved with the patient early on in the disease, so that the palliative care team can work with the treating doctor in order to improve the quality of life of the patient – because that is the main thing. We want quality of life for the patient, not necessarily quantity of life, but quality of life is important.”

Swart says the patient will gain more from the treatment, if the palliative care team has enough time to build a relationship with the patient and family in order to provide optimal support.

(Thania Gopal, Health24, April 2009)

Sources:
www.webmd.com
www.getpalliativecare.org
Dr Teresa Swart, Part-time lecturer in palliative care at Stellenbosch University, currently completing her masters degree in palliative medicine
Elizabeth Scrimgeour, Executive Officer of the Drakenstein Palliative Hospice and Chairperson of the Western Cape Hospice Palliative Care Association

 
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