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Palliative
Care
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. 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 counseling, if indicated;
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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.
WHO definition 2002
Hospice
Hospice [care] = Support and care for persons in
the last phase of an incurable disease so that
they may live as fully and comfortably as
possible. Hospice [care]:
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recognizes that the dying process is a part of
the normal process of living and focuses on
enhancing the quality of remaining life.
-
affirms life and neither hastens nor postpones
death.
-
exists in the hope and belief that though
appropriate care, and the promotion of a caring
community sensitive to their needs, that
individuals and their families may be free to
attain a degree of satisfaction in preparation
for death.
-
recognizes that human growth and development can
be a lifelong process.
-
seeks to preserve and promote the inherent
potential for growth within individuals and
families during the last phase of life.
-
offers palliative care for all individuals and
their families without regard to age, gender
nationality, race, creed, sexual orientation,
disability, diagnosis, availability of a primary
care giver, or ability to pay.
Hospice programs provide state-of-the-art
palliative care and supportive services to
individuals at the end of their lives, their
family members and significant others, 24 hours
a day, seven days a week, in both the home and
facility-based settings. Physical, social,
spiritual and emotional care are provided by a
clinically-directed interdisciplinary team
consisting of patients and their families,
professionals and volunteers during the:
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Last stages of an illness;
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Dying process; and
-
Bereavement period.
Hospice Standards of Practice, National Hospice
and Palliative Care Organization, 2000.
Hospice in context of
Nepal
Cancer is on the increase in Nepal. More often
than not, the patients present at a late stage
when therapeutic options no longer remain an
option. Even when the patient present with an
early disease, it can either be cured or after
remaining confined by surgery, chemotherapy or
radiotherapy for a certain period, it will
eventually escape and become disseminated in the
body. When such a stage is reached, many
physician feel helpless as there seems very
little one can do but to look helplessly as the
patient slowly withers away. Because of
constraints of resources in hospitals, the
palliative services are seldom possible and
families have to take their loved ones home
where adequate nursing care, pain and symptoms
control cannot be achieved. It is painful to see
our loved ones die, but is even more distressful
to see them suffer.
Hitherto, there was no dedicated hospice service
in Nepal. In year 2000, we launched Hospice
Nepal to provide hospice service in a very
humble manner with just four beds. We offered
free bed in the general ward, free nursing care
and free doctor's consultation. |
