According to the World Health Organization (WHO), palliative care is a set of care, made for the person suffering from a serious or incurable disease, and also their family, with the aim of alleviating their suffering, being and quality of life.
The types of care that may be involved are:
- Identify and treat physical symptoms that can be uncomfortable like pain, shortness of breath, vomiting, weakness or insomnia, for example;
- Identify and care for negative psychological feelings or symptoms, such as distress or sadness;
- Observe and support in the management of conflicts or social difficulties, which may impair care, such as lack of care;
- Recognize and support spiritual issues , such as offering religious help or guidance regarding the meaning of life and death.
All these care can not be offered only by the doctor, and there must be a team composed of doctors, nurses, psychologists, social workers and other professionals such as physiotherapists, occupational therapists, nutritionists and a chaplain or other spiritual representative.
In Brazil, palliative care is already offered by many hospitals, especially those with oncology services, however, there is still a great lack of professionals and teams dedicated to its implementation, since, ideally, there should be teams available for care in general hospitals, outpatient visits, and even at home.
Who needs palliative care
Palliative care is targeted at all people who suffer from a life-threatening condition that worsens over time and is also known as terminal illness. Thus, it is not true that this care is done when there is no longer "nothing to do", because it can still be offered essential care for the well-being and quality of life of the person, regardless of their life span.
Some examples of situations where palliative care applies, be it for adults, the elderly, or children, include:
- Cancer;
- Neurological degenerative diseases such as Alzheimer's, Parkinson's, multiple sclerosis, or amyotrophic lateral sclerosis;
- Other chronic degenerative diseases, such as severe arthritis;
- Diseases that lead to organ failure, such as chronic kidney disease, terminal heart disease, pneumopathies, liver disease, among others;
- Advanced AIDS;
- Any other life threatening situations, such as severe head trauma, irreversible coma, genetic diseases or incurable congenital diseases.
Palliative care also serves to care for and support the families of people suffering from these diseases, by offering support in relation to how care should be, solving social difficulties and better grief, for situations such as dedicating oneself to caring for someone or dealing with the possibility of losing a loved one are difficult and can cause a lot of suffering in the family.
What is the difference between palliative care and euthanasia?
While euthanasia proposes to anticipate death, palliative care does not support this practice, which is illegal in Brazil. However, they also do not wish to postpone death, but rather, they propose to allow the incurable disease to follow its natural path, and for that, it offers all the support so that any suffering is avoided and treated, generating an end of life with dignity. Understand the differences between euthanasia, orthanasia and dysthanasia.
Thus, despite not approving euthanasia, palliative care does not support the practice of treatments considered futile, that is, those that only intend to prolong the life of the person, but that will not cure it, causing pain and invasion of the privacy.
How to receive palliative care
Palliative care is indicated by the doctor, however, to ensure that they are done when the time comes, it is important to talk to the medical staff accompanying the patient and show their interest in this type of care. Thus, clear and frank communication between the patient, the family and the doctors about the diagnosis and treatment options of any disease is very important to define these issues.
There are ways of documenting these wishes through documents called "Advance Directives, " which allow the person to tell their doctors about the health care they want, or do not want to receive, if, for any reason, they find themselves unable to express wishes regarding treatment.
Thus, the Federal Council of Medicine directs that the registration of the advance directive of will can be made by the doctor accompanying the patient, in his medical record or in the medical record, as long as it is expressly authorized, and no witnesses or signatures are required, by its profession, has public faith and its acts have legal and legal effect.
It is also possible to write and register in a notary's office a document, called a Living Will, in which the person can declare these wishes, specifying, for example, the desire not to be subjected to procedures such as breathing apparatus, feeding through tubes or passing by a cardiopulmonary resuscitation procedure, for example. In this document you can also indicate a trusted person to make decisions about the course of treatment when you can no longer make your choices.
