The World Health Organization definition states: “Palliative care is an approach that promotes the quality of life of patients and families dealing with a life-threatening illness, through the prevention and relief of suffering, by early identification and treatment of the disease. pain and other physical, psychosocial and spiritual problems”.
At Oncoclínicas, palliative care is assistance provided by a multidisciplinary team, whose essence is to promote the relief of symptoms, pain and suffering through a holistic approach in the search for a better quality of life for people diagnosed with advanced cancer. or with symptoms that are difficult to control.
The term “palliative” derives from the Latin pallium, which means protective cloak, and palliare means to protect, welcome, support. This is the meaning of palliative, derived from the Latin term that names the cloak that knights used to protect themselves from storms along the paths they traveled. Protecting someone is a form of care.
The interdisciplinary palliative care team coordinates and oversees all aspects of patient care. This team is responsible for making sure that everyone involved shares patient information. This may include inpatient staff, home care, primary care staff, and other community professionals such as pharmacists, chaplains, social services, and others.
This approach improves the quality of life of the patient and those close to him, who face with him the issues associated with the disease; Some examples of diseases that benefit from this approach are cancer, coronary diseases such as heart failure, dementia, such as Alzheimer’s, among others.
In the case of oncological diseases, palliative care professionals assess how the cancer is affecting the patient and help relieve symptoms, pain and stress. They offer patients options and allow them and their caregivers to participate in planning their care, which includes helping to manage mental, physical, emotional, social and spiritual problems. The goal of controlling pain and other symptoms is to help the patient feel more comfortable, allowing symptoms to be controlled for a better quality of life.
Spiritual care. Since people have different religious beliefs as well as spiritual needs, spiritual care is configured to meet the specific needs of each patient.
Family meetings. Family meetings often conducted by staff members keep the patient’s family members informed about their condition and what to expect. These meetings make it possible to share feelings, give the opportunity to talk about what is happening, allow questions to be answered and help address the need to learn to deal with finitude and the process of death. Family members can find support and great relief in these encounters. Daily patient updates can also be obtained informally in conversations with the nursing staff.
Palliative care should be started as early as possible in cancer patients. They may be associated with treatment aimed at curing the disease, assuming an important role in helping to manage difficult-to-control symptoms and improve the patient’s clinical conditions.
It is essential to understand that the patient with a disease such as cancer does not have to choose between the medical team with treatment directed to their disease (oncologists and hematologists, for example) and the palliative care team. Advanced cancer diseases or people undergoing cancer treatment with symptoms that are difficult to control benefit from receiving this joint care.
Care takes place in an integrated manner, with the entire medical and multidisciplinary team performing extremely important functions. Palliative doctor, nurse, social worker, pharmacist, physiotherapist, occupational therapist, psychologist, nutritionist, speech therapist and spiritual assistant work together in search of the best conditions for the patient and their support network.
As the disease progresses, even when treatment with curative intent is ongoing, the palliative approach must be extended to psychological, social and spiritual aspects. In the terminal phase, the palliative care approach also continues as a way to ensure the patient’s quality of life, comfort and dignity.
In the oncology scenario, the ASCO (American Association of Clinical Oncology) established in 2017 which patients should be in the follow-up of palliative care. Are they:
Advanced stage cancer patients (with metastases); and People undergoing cancer treatment with symptoms that are difficult to control at any stage of the disease.
In addition to these situations, the literature shows that patients with advanced or refractory hematological malignancies and those with a high burden of symptoms and/or biopsychosocial needs also benefit from this approach.
Monitoring by the palliative care team brings several benefits, such as improved symptom control, care with a comprehensive view of the patient and their family, appreciation of the patient’s autonomy, always respecting their values and priorities, individualized care planning, according to with the physical, social, family, emotional and spiritual needs and context of each patient, a humanized vision and prevention of stress for those involved in patient care and support from a transdisciplinary team in the period of coping with the disease and its treatment.
Palliative Medicine has been a practice area of medicine in Brazil since 2011, and in countries like the United Kingdom it has been a specialty since 1987. The medical professional obtains training in palliative medicine through a medical residency or postgraduate program at area. It is important to emphasize that the palliative doctor, as he is informally called, always works with the interdisciplinary team to carry out a complete palliative care approach .