In recent decades are seeing a gradual increase in the prevalence of some chronic diseases, with the progressive aging of the population. Progress in cancer-specific treatment has allowed a significant increase in survival and quality of life of these patients. More recently, diseases such as AIDS have broken into our society demanding a public health response. Despite these advances, a large group of patients die from their disease. Palliative Medicine is the study and management of patients with advanced, progressive and incurable, life-prognosis limited and designed to achieve the best possible quality of life. Palliative care consists of the comprehensive care of patients whose disease is not responsive to curative treatment. The purpose of this care is to achieve the best quality of life for patients and their families, promote life and consider the process of dying a natural fact, without shortening the life or prolong it unnecessarily.
terminal patient's rights, established by WHO in 1990, agreed to the exercise of Palliative Medicine and include, among others, the right to participate in treatment decisions, not to die alone or with pain, do not be deceived, for assistance on behalf of and for the family.
A health professionals they have been intended to diagnose, fight disease, identify its causes and, where possible, implementing preventive measures. When the means and remedies fail and the patient enters a terminal phase, the medical and health professionals are left with a profound sense of impotence, to the inevitable. The proposal of palliative medicine is a response to this painful situation: when the end is irreversible in both children and adults, helps reduce pain and relieve patient suffering, containing both it and their loved ones.
A major goal of hospice is to control pain and other symptoms so the patient can remain as alert and comfortable as possible. Palliative care services are available for people who can no longer benefit from curative treatments, the typical hospice patient has a prognosis of 6 months or less. Palliative care programs provide services in various situations: at home, in hospices, hospitals or skilled nursing facilities. Families of patients are also an important focus of palliative care, and services are designed to provide assistance and support they need. Before
to admit the patient in the hospice program is important to be sure that it is a terminal patient, and not a critically ill patient or a chronic far advanced. It is emphasized that palliative care be implemented by a multidisciplinary team as well as the duty of the doctor (usually a clinician or internist) requires the intervention of other professionals, nurses, psychologists, physiotherapists, nutritionists, etc. It is imperative that the various health professionals maintain equipment including regular meetings serve to coordinate the relief effort.
Clearly beyond the underlying disease (cancer, AIDS, or multi-system organ failure) and patient characteristics, it is necessary for symptom control is effective for the patient have an acceptable quality of life. Of all the most feared symptom is pain, and spoke of physical pain, mental pain, social pain, spiritual pain. We are not able to assess total pain objectively. We can approach by assessing (not measured) in a terminal patient.
Today we can not include death in our way of life because we live in an eternal present, and lack of time. A person to die on a respirator, in addition to being a totally inhuman tells us what we have learned from our current way of life. A patient without any possibility of recovery is subject to a number of practices "disproportionate", which only serve to prolong the agony, is an expression of therapeutic cruelty (dystanasia).
palliative care represent a valid alternative to provide a dignified death to terminally ill patients, but it would be illusory to believe that constitute the solution of all cases. Evidence of this failure are the increasing social and vocational permeability is seen in some first world countries to the possibility that the patient chooses or passive euthanasia assisted suicide, thus responding to a self-end.
For more information and the recommendations of the English Society of Palliative Care (SECPAL) you can click here.
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