Palliative care, emotional care, terminal care, pain management, these are all examples of care for someone with an incurable disease or condition.
What is Palliative Care?
The World Health Organization has defined palliative care as: ‘the active comprehensive care of patients, preventing and relieving pain and minimizing emotional, social and spiritual problems when a disease does not respond to active treatment.’
Palliative care can also be interpreted differently. The word palliative comes from the Latin word Pallium , which means mantal, which is worn by a priest of the church. A cloak hides or covers something. Perhaps this word was chosen to indicate the protection of patients suffering from complex symptoms or incurable diseases.
Palliative care consists of easing the patient’s suffering and achieving the highest possible quality of life. Spirituality
is also taken into account in palliative care. It often happens that people with a particularly advanced form of cancer are afraid of death or what happens next.
Palliative care briefly consists of:
- Palliative medical care
- Palliative and terminal care
- Psychological guidance and spiritual guidance
- Palliative radiotherapy
Palliative, terminal and active phase of death
There is a misconception that palliative care is only suitable for patients in the terminal phase, the last phase (the active death phase). Patients who are dying only require palliative care when controlling symptoms becomes the main concern. Terminal care is only part of palliative care.
The term terminal is often used inappropriately in the medical world. People who go to a doctor and are told that they have a terminal form of cancer immediately feel like they are dying. A terminal status can last weeks to months depending on the disease and its phase. It depends on how the patient feels and behaves whether he is in a terminal or death phase. The Eastern Cooperative Oncology Group (ECOG) has drawn up a table that can assist in patient classification. the table is divided from points 0 to 4.
0 The patient has no symptoms, is eating well and is ambulatory. 4 The patient is completely bedridden and unable to care for himself, does not eat or drink enough. And has an incurable disease. The prognosis is death and the patient will probably soon enter the final phase.
Stage 4 but no final stage
There are patients who are in stage 4 but are not in the final phase (the death phase) because they have a curable disease, such as patients who have been diagnosed with acute leukemia.
Most common diseases/conditions that are treated palliatively
In general, palliative care is used for cancer patients, but also for patients with incurable neurological diseases such as Alzheimer’s, Huntington’s or the final phase of Multiple Sclerosis.
Palliative sedation and Euthanasia.
If one is in phase 4 (in the case of euthanasia also before phase 4) and there is no longer a chance of recovery, palliative sedation or euthanasia is often considered.
The difference between palliative sedation and euthanasia
Characteristics of alliative sedation:
- lowering consciousness with normal medical care and, if possible, with the patient’s consent.
- This can be carried out by a doctor or nurses.
- The medication is administered based on the relief of suffering
- Only used in the final stages of life
- The lowering of consciousness can possibly be reversed.
- Life is not shortened.
- In the case of sedation, the complaints are often of a physical nature.
Characteristics of Euthanasia:
- termination of life with special medical treatment; This is only possible with prior consent from the patient, primary physician and supervising physician.
- This may only be carried out by a doctor.
- The medication is administered by overdose.
- Can also be performed for the final phase of life
- Once euthanasia has been performed, it cannot be reversed.
- Life is unnaturally shortened.
- In the case of euthanasia, the complaints are of a physical nature but also often of a psychological nature. Euthanisia is often used to avoid dying undignified.
Agreement on palliative sedation and euthanasia
Both aim to alleviate the patient’s suffering.
Home care
Most patients are cared for at home, in their environment, with their family members. If this is not possible because the care is too difficult or because you have to wait too long for home care, the patient can be cared for in the hospital or nursing home.