Palliative care embodies the fundamental right of individuals to maintain their dignity throughout life's final stages, free from pain, fear, and isolation. This comprehensive approach extends support not only to the patient but also to their family, prioritizing the preservation of the highest possible quality of life until the end.
Palliative care aims to ease pain and distressing symptoms while providing holistic care that includes social, psychological, and spiritual support for both the patient and their families.
Types of Organising Palliative Care
The aim of palliative care is to give the patient the best possible quality of life. It is not limited to a list of specific diagnoses. It is also an important part of palliative care to work with the patient's family and support them through the illness.
There are three types of palliative care:
- Palliative care, the main aim of which is to provide comprehensive care for the patient;
Palliative care deals with all the problems of a terminally ill person, such as providing a place to live in the last days of life and pain management. Hospice staff also look after all the patient's other needs: physical, spiritual, emotional and social. Admission to hospice care requires a doctor's recommendation. The reasons for this may be an incurable illness at a serious stage, a pain syndrome that cannot be controlled at home, inability to be cared for by relatives, etc.
- End-of-life care is comprehensive palliative care for the patient in the last days of life;
End-of-life care can refer to palliative care in the last two or three days before death, as well as care for patients dying in non-specialist hospitals. In some countries, it also includes last medical care for patients who do not need palliative care.
- Weekend care is provided on specific days so that family members who are constantly caring for the patient can rest.
It is provided by professionals in day centres, palliative care units or mobile home care services, using Digital technologies like telemedicine services in combination with Practice Management Software. We’ll talk about them further in the article.
How Can Palliative Care Be Organised?
There are three ways in which palliative care can be organised:
- At home
Palliative care at home can only be organised if the pain unit to which the patient belongs has its own transport. Home care includes pain management, nursing, social and psychological support. As there are few hospices and palliative care units in our country, many patients have to be discharged home after treatment, where only their relatives take care of them. For this reason, home visits are sometimes carried out by volunteers and private hospices, in addition to state organisations. This method does not mean that a specialist is with the patient around the clock. Most care is still provided by family members, who sometimes have to give up their jobs to care for the patient.
- As a day hospital
The medical staff will see the patients, treat them in the day hospital and provide the necessary counselling. If there is no day hospital, it is possible to allocate several beds from an ordinary hospital to a pain clinic. This is only acceptable for patients whose condition allows them to come to the pain clinic on their own, which is not possible in severe cases.
- Inpatient care
Palliative care is also provided on an inpatient basis: in specialist care and nursing units in hospitals, hospices and nursing homes. Inpatient care is provided 24 hours a day by specially trained medical staff. It includes medical interventions for pain management, hospitalisation, nutrition, psychological support for patients and their families, etc. Hospital-based palliative care is recommended in most cases, but many patients prefer to spend their final days at home in a familiar environment.
Palliative Care Approaches
Palliative care is a combination of three approaches, which can’t be which cannot be considered separately. They are:
Pain Management
This involves symptomatic treatment to relieve the pain caused by the illness. The aim is to provide the best possible quality of life with a minimally favourable prognosis.
Effective pain management requires an accurate assessment of the nature of the pain, a tactic to control it, and appropriate care for the patient. For example, in the case of severe daily migraines, taking painkillers alone may only provoke new attacks. A palliative care specialist, especially a neurologist, will prescribe the appropriate treatment, advise on a series of physical rehabilitation measures, and work out the right daily routine. Medication is the most accessible and easiest way to control pain.
Psychological Support
Serious illness, hospitalisation, surgery, change of lifestyle, possible disability and the threat of death have a negative effect on the psychological state of the patient. The patient is unable to adapt to the new circumstances and has a constant feeling of fear and doom, which has a negative effect on the general state of mind.
Family members are also often unable to support the patient psychologically, as they themselves experience stress. Palliative care involves psychologists working with both the patient and the family. Volunteers are sometimes involved in this work. Religious ceremonies can be organised at the patient's request.
Social Support
Palliative care includes social support for the patient's family and for the patient. Psychological problems are exacerbated by the realisation of social difficulties caused by the cost of care and treatment. Many patients have material problems, some need to improve their living conditions, but very few are aware of the social benefits available to them.
Social workers are obliged to study the patient's social problems, draw up a social rehabilitation plan together with the doctors, inform the patient about his rights and possible benefits and help him to obtain them.
Advantages of Telemedicine in Palliative Care
Many healthcare providers are using telemedicine services to facilitate patient care. Telemedicine can play a significant role in organizing palliative care by providing various benefits and improving access to essential services for patients facing serious illnesses. Here are several ways telemedicine can aid in organizing palliative care:
- Remote Consultations
- Telemedicine enables healthcare teams to conduct remote consultations with patients and their families. This allows for timely discussions about symptom management, treatment options, and care planning without the need for in-person visits.
- Monitoring Symptoms
- Through telemedicine platforms, healthcare professionals can remotely monitor patients' symptoms and adjust treatment plans accordingly. This real-time monitoring helps in early identification of any deterioration in the patient's condition, allowing for prompt intervention.
- Education and Support
- Telemedicine facilitates the delivery of educational resources and support services to patients and their families. This includes providing information about medication management, coping strategies, and emotional support, thereby improving overall care coordination and patient outcomes.
- Access to Specialists
- Telemedicine enables caregivers to consult with specialists, such as pain management experts, psychologists, and social workers, regardless of geographical barriers. This ensures that patients receive comprehensive and multidisciplinary care tailored to their specific needs.
- Reducing Travel Burden
- For patients living in remote or underserved areas, accessing palliative care services can be challenging due to travel constraints. Telemedicine eliminates the need for long-distance travel by allowing patients to receive consultations and follow-ups from the comfort of their homes, reducing both physical and financial burdens.
- Enhancing Communication
- Telemedicine facilitates communication among members of the palliative care team, including physicians, nurses, social workers, and chaplains. This improves care coordination, ensures continuity of care, and enables timely sharing of information, ultimately benefiting the patient and their family.
- Advance Care Planning
- Telemedicine platforms can support advance care planning discussions by providing a convenient and accessible platform for patients to express their preferences regarding end-of-life care. This ensures that patients' wishes are documented and respected, leading to more personalized and patient-centered care.
Overall, telemedicine offers a valuable tool for organizing and delivering palliative care by overcoming geographical barriers, improving access to specialized services, enhancing communication, and empowering patients and their families or loved ones to actively participate in their care.
Conclusion
In conclusion, we can say that palliative care provides invaluable support to individuals facing life-limiting illnesses and their families. Through its focus on alleviating suffering, enhancing quality of life, and fostering meaningful connections, palliative care transcends the boundaries of traditional medical treatment to address the needs of patients. While the landscape of healthcare continues to evolve, the principles of palliative care remain steadfast, emphasizing dignity, respect, and dignity throughout every stage of illness.
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