The idea of being sick and unable to care for yourself or becoming a burden to friends and family is a source of great concern to many people. Serious illnesses can cause physical symptoms, such as pain, nausea or fatigue. You may also have psychological symptoms like depression or anxiety.
The palliative care approach provides specialised care, focusing on the reduction of pain and symptoms of life-threatening illness.
World Health Organisation definition of palliative care
Palliative care is defined by the World Health Organization (WHO) as an approach that improves the quality of life of patients and their families facing the problems 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, 2003).
According to Dr Teresa Swart, currently completing her masters degree in palliative medicine, the palliative care approach differs from normal medicine since it takes into consideration the psychosocial problems of the patient, as well as the family.
“The patient has a bigger say in palliative care. You will find that normal medicine is more paternalistic, where the doctor tells you what to do. In palliative care we find out what the patient’s needs and wishes are. For instance, if the patient would like to die at home, we will work on that,” says Swart.
'Philosophy of care'
“Elizabeth Scrimgeour, Executive Officer of the Drakenstein Palliative Hospice and Chairperson of the Western Cape Hospice Palliative Care Association, says palliative care is really a “philosophy of care”.
“What makes palliative care different to normal care is that we work with an interdisciplinary team which consists of all the various disciplines like social workers, occupational therapists, doctors, professional nurses etc. Training is one of the cornerstones of the work that we do.”
She says palliative care includes the care of sick children and orphans. “It’s really a professional family approach to care, focussing on symptoms and on symptom management.”
The WHO definition of Palliative Care (2009) states that palliative care:
- provides relief from pain and other distressing symptoms
- affirms life and regards dying as a normal process
- intends neither to hasten or 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 patients illness and in their own bereavement
- uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated
- will enhance quality of life, and may also positively influence the course of illness
is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.
(Thania Gopal, Health24, April 2009)
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