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Palliative Care Image courtesy of fightmesotheliomacancer.com Julianna Tambellini, Meredith Hennon, University of Pittsburgh USA.

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Presentation on theme: "Palliative Care Image courtesy of fightmesotheliomacancer.com Julianna Tambellini, Meredith Hennon, University of Pittsburgh USA."— Presentation transcript:

1 Palliative Care Image courtesy of fightmesotheliomacancer.com Julianna Tambellini, Meredith Hennon, University of Pittsburgh USA

2 What is Palliative Care? Medical care that focuses on alleviating the intensity of symptoms of disease. Palliative care focuses on reducing the prominence and severity of symptoms.

3 What is Palliative Care? The World Health Organization describes palliative care 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."

4 WHO Definition of Palliative Care 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;

5 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; 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 of Palliative Care (cont.)

6 What is the goal of Palliative Care? The goal is to improve the quality of life for individuals who are suffering from severe diseases. Palliative care offers a diverse array of assistance and care to the patient.

7 The History of Palliative Care Started as a hospice movement in the 19 th century, religious orders created hospices that provided care for the sick and dying in London and Ireland. In recent years, Palliative care has become a large movement, affecting much of the population. Began as a volunteer-led movement in the United states and has developed into a vital part of the health care system.

8 Palliative vs. Hospice Care Division made between these two terms in the United States Hospice is a “type” of palliative care for those who are at the end of their lives. Image courtesy of

9 Palliative vs. Hospice Care Palliative care can be provided from the time of diagnosis. Palliative care can be given simultaneously with curative treatment. Both services have foundations in the same philosophy of reducing the severity of the symptoms of a sickness or old age. Other countries do not make such a distinction

10 Who receives Palliative Care? Individuals struggling with various diseases Individuals with chronic diseases such as cancer, cardiac disease, kidney failure, Alzheimer's, HIV/AIDS and Amyotrophic Lateral Sclerosis (ALS)

11 Cancer and Palliative Care It is generally estimated that roughly 7.2 to 7.5 million people worldwide die from cancer each year. More than 70% of all cancer deaths occur in developing countries, where resources available for prevention, diagnosis and treatment of cancer are limited or nonexistent. More than 40% of all cancers can be prevented. Others can be detected early, treated and cured. Even with late-stage cancer, the suffering of patients can be relieved with good palliative care.

12 Palliative Care and Cancer Care Palliative care is given throughout a patient’s experience with cancer. Care can begin at diagnosis and continue through treatment, follow-up care, and the end of life.

13 Palliative Care and Cancer "Everyone has a right to be treated, and die, with dignity. The relief of pain - physical, emotional, spiritual and social - is a human right," said Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. "Palliative care is an urgent need worldwide for people living with advanced stages of cancer, particularly in developing countries, where a high proportion of people with cancer are diagnosed when treatment is no longer effective."

14 “Cancer Control: Knowledge Into Action” Excerpts from the WHO guide for Palliative Care: “Palliative care is an urgent humanitarian need worldwide for people with cancer and other chronic fatal diseases. Palliative care is particularly needed in places where a high proportion of patients present in advanced stages and there is little chance of cure.”

15 Who Provides Palliative Care? Usually provided by a team of individuals Interdisciplinary group of professionals Team includes experts in multiple fields: Doctors Nurses social workers massage therapists Pharmacists Nutritionists

16 Patient and Family Volunteers Physicians Spiritual Counselors Social Workers Pharmacists Home Health Aides Therapists Nurses

17 Approaches to Palliative Care Not a “one size fits all approach” Care is tailored to help the specific needs of the patient Since palliative care is utilized to help with various diseases, the care provided must fit the symptoms. Image courtesy of uwhealth.org

18 Palliative Care Patient Support Services Three categories of support: 1. Pain management is vital for comfort and to reduce patients’ distress. Health care professionals and families can collaborate to identify the sources of pain and relieve them with drugs and other forms of therapy.

19 Palliative Care Patient Support Services 2. Symptom management involves treating symptoms other than pain such as nausea, weakness, bowel and bladder problems, mental confusion, fatigue, and difficulty breathing

20 Palliative Care Patient Support Services 3. Emotional and spiritual support is important for both the patient and family in dealing with the emotional demands of critical illness.

21 What does Palliative Care Provide to the Patient? Helps patients gain the strength and peace of mind to carry on with daily life Aid the ability to tolerate medical treatments Helps patients to better understand their choices for care

22 What Does Palliative Care Provide for the Patient’s Family? Helps families understand the choices available for care Improves everyday life of patient; reducing the concern of loved ones Allows for valuable support system Image courtesy of mdanderson.org

23 Approaches to Palliative Care A palliative care team delivers many forms of help to a patient suffering from a severe illness, including : Close communication with doctors Expert management of pain and other symptoms Help navigating the healthcare system Guidance with difficult and complex treatment choices Emotional and spiritual support for the patient and their family

24 Palliative Care Is Effective Successful palliative care teams require nurturing individuals who are willing to collaborate with one another. Researchers have studied the positive effects palliative care has on patients. Recent studies show that patients who receive palliative care report improvement in: Pain and other distressing symptoms, such as nausea or shortness of breath Communication with their doctors and family members Emotional and psychological state

25 Where to find Palliative Care? In most cases, palliative care is provided in the hospital. The process begins when doctors refer individuals to the palliative care team. In the hospital, palliative care is provided by a team of experts. The Palliative Care Provider Directory of Hospitals at can locate hospitals which provide palliative care.

26 Settings for Palliative Care Outpatient practice Hospital Inpatient Unit based Consultation Team Home care Nursing Home Hospice

27 Cost of Palliative Care Mostinsurance plans cover all or part of thepalliative care treatment given in hospitals. Medicare and Medicaid alsotypically coverpalliative care.

28 Palliative Care is Growing Data suggest there is growth in palliative care programs throughout the nation's hospitals, larger hospitals, academic medical centers, not-for-profit hospitals, and VA hospitals are significantly more likely to develop a program compared to other hospitals.

29 Palliative Care is Universal Numerous governments have already adopted national palliative care policies, including Australia, Canada, Chile, Costa Rica, Cuba, France, Ireland, Norway, Spain, Uganda, South Africa and the United Kingdom.

30 Palliative Care in WPRO The Western Pacific Regional Office (WPRO) represents the WHO in 37 countries of Asia Pacific. About a quarter (25%) of the countries in the WPRO region have an established system (“approaching integration”) for palliative care that encompasses the entire country or have services typically in large cities or highly populated regions (“localized provision”).

31 Countries with established systems Australia In 1987, Ian Maddocks accepted the world’s first Chair in Palliative Care at Flinders University. Palliative care is recognized as a medical specialty in Around 320 palliative care services are operational. Japan Palliative care standards were first introduced in Palliative care education is included in the curriculum of most medical schools in the country and all nursing schools. 120 services related to palliative care are available country-wide. Singapore 13 organizations providing palliative care. Palliative care module added to medical school curriculums.

32 Countries with established systems Malaysia In 1998, the Government began requiring every district and general hospital to introduce a palliative care provision. Mongolia Palliative care incorporated into National health plan. Palliative care module included in medical school curriculum. New Zealand A palliative care education program has been established for care assistants. 41 services are currently delivering palliative care throughout the country.

33 Countries with localized provisions China South Korea Philippines Vietnam

34 Countries with building capacity Brunei Darussalam Fiji Papua New Guinea The countries are aiming to create conditions for the development of programs focused on palliative care.

35 Countries with no palliative care American Samoa Cook Islands French Polynesia Guam Kiribati Laos Marshall Islands Micronesia Nauru New Calendonia Niue Northern Mariana Islands Palau Pitcairn Islands Samoa Soloman Islands Tokelau Tonga Tuvalu Vanuatu Wallis and Futuna

36 WPRO Palliative Care Systems

37 Bibliography Palliative%20Care%20Module.pdf Palliative%20Care%20Module.pdf lliative-care lliative-care


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