Experts Say Palliative Advancement Required To Offer Quality Of Life To A Greater Number Of People

The role of palliative care for people who reach the end of life without proper well-being and dignity is fundamental. According to the World Health Organization (WHO), of the approximately 56.8 million people who need palliative care worldwide, including 25.7 million who are in the last year of life, only 14% are assisted in order to receive treatment that improves the quality of life of the patient, family members and close friends.

Considering death a natural process is still a taboo. However, medicine, aligned with other pillars such as psychology and spirituality, rebuild this culture by implementing palliative care to provide well-being for terminally ill patients or those with a potentially fatal chronic illness.

Professor Marysia Prado De Carlo, from the Occupational Therapy course at the Faculty of Medicine of Ribeirão Preto (FMRP) at USP explains that it is an interprofessional approach to be able to understand the processes experienced by patients in all their dimensions, whether physical, emotional, social and spiritual.

In addition, the expert believes that there is a misconception about when palliative care should be applied and to whom. According to her, the approach can be offered at any stage of the disease’s development. “International studies have shown that the earlier palliative care is offered, the better the patient’s response and the better living conditions he will have as long as he lives”, she explains.

The therapist defends that, from the diagnosis of a potentially fatal disease, the bearer has the necessary access to all kinds of palliative care in order to improve his quality of life, his well-being, the correct management of pain, symptoms and existential spiritual suffering. “So it’s always important to highlight that palliative care is not talking about death all the time, it’s talking about life, quality of life”, she points out.

According to WHO, palliative care is necessary for a wide range of illnesses. The most common among adults are cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%).

In addition, the organization points out that many other conditions may require palliative care, including kidney failure, chronic liver disease, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological disease, dementia, congenital anomalies and drug-resistant tuberculosis.

essential pillar
While receiving palliative care, the patient’s family plays a fundamental role and, for this, this support network also needs to be taken care of by professionals. “The family also suffers a lot when there is a diagnosis of a potentially fatal disease, it has to be taken care of too”, says Marysia.

According to the professor, the patient’s relatives participate in the definition of all processes related to the treatment, from the options regarding what the person wants for the end of life to the place of death. “The family has to play an active role in this process, not only to help the sick person to live in a better way, but also for them to be welcomed within their own needs.”

Clinical treatments
As much as the palliative care approach allows patients to have a better quality of life, well-being and symptom relief, general practitioner Vinicius Akio Suzuki points out that this does not exclude clinical treatments. For him, it is extremely important to understand that they complement each other. “This notion is fundamental for breaking the main paradigm we face on a daily basis: guilt and abandonment by the family”, he reflects.

Unlike other already developed countries, Latin Americans have their own culture of approaching life values ​​and their terminality. “When the patient is already critical and on the intensive care bed, we are faced with his fragility and that of many families as well. Welcoming the needs of those who are leaving as well as those who remain is fundamental for us to have more humanity in the world”, argues Suzuki.

“From the palliative perspective, the therapeutic strategy is important, having foundations in its pillar, but human needs turn out to be much more complex, having to deal not only with the physical, but also with the mental, emotional, social and spiritual”, he concludes.