A lot of advances in medical scientific technologies in the last few centuries have facilitated and prolonged life and in the same way delayed death. These advances in clinical and biomedical medicine have greatly enabled the treatment and/or prevention of numerous diseases.
For the first time, the palliative care was defined by the WHO (World Health Organization) in 1989 as ‘an approach which helps to improve the life of patients as well as their families which are facing life-threatening illness problems, by providing the relief and prevention of suffering through identifying early the symptoms of the disease and then perform an impeccable assessment to treat the pain and many other problems such as physical, spiritual, and psychosocial.
WHO has modified the definition of palliative care in 2014: ‘Palliative care is surely the responsibility of every physicians’, which defined palliative care more comprehensive? It is the multidisciplinary care which is intending to palliate or prevent the symptoms, provide relief from suffering, and improves the quality of life. It is also noted that palliative care shouldn’t be applied only to patients who are in their final stages of life, but it must be integrated completely into the curative and medical care as well as life-long treatment, irrespective of only disease stage. During palliative care, it is very essential to provide family support, specific care to patients, effective communication, and multidisciplinary teamwork. Briefly, it is the philosophy of care and it is based upon the support of families and hostile care including a mourning period (Murat Can Mollaoğlu, 2019).
In a nutshell, the major objectives of palliative care are to entirely restore overall patient’s functional capacity by being sensitive towards local and cultural values, beliefs, as well as, practices of the individual, for alleviating pain, and for improving the quality of life by symptoms controlling. Moreover, the aim is to eliminate or reduce the disease symptoms without doing any further examination when there is no longer possibility of curing the disease. Certainly, the WHO is expecting a lot from the team of palliative care in terms of providing respect to patients and considering their wishes (Tanrıverdi Ö, 2016).
Approaches of Palliative Care in Health Delivering:
A palliative approach constructs on numerous of the significant principles foundational to specified palliative care services. Such as specific palliative care is the palliative approach that emphasizes on cantered care of patients and their families and focuses not only on diseases but also on a person, where the quality of life is considered as a primary goal. According to the studies, the best palliative approach is to develop the best therapeutic relationships among providers, patients, and its family with more emphasis is giving on developing partnerships to improve care quality. Furthermore, a lot of stress is given on a clear communication during the whole illness trajectory, predominantly on the subject of conversations regarding advance care plans, care goals, “breaking of bad news”, as well as, shifts in the management of a disease process and/or the plan/strategy of care. The palliative approach depends on the foundations of palliative care which put great emphasis on a careful assessment as well as management of symptoms associated with disease and give importance to compassionate and provide skilled care to patients who are dying imminently (Connor SR, 2015).
Thus, the palliative approach is fundamentally the adoption of foundational palliative care principles, the adaption of the significant knowledge on palliative care, and expertise to an illness trajectories of people facing chronic life-threatening conditions, and then entrenching this adapted information or knowledge and expertise “upstream” into the delivery of care across various healthcare professions and sectors. So, the three main characteristics of the palliative approach are as follows:
- The upstream orientation to health care (to make sure the basic needs of all patients and their families are addressed in early-stage as well as throughout the entire illness trajectory of individuals who are facing chronic life-limiting conditions).
- Adaptation of palliative care expertise and knowledge
- Operationalization of the palliative approach by contextualization and integration within healthcare systems (Sawatzky, 2016).
Promotion of Best Practices in the Clinical Area:
Palliative care is intending to accomplish the best promising life for people and their families who are dying due to some illness whereas health promotion is intending to assist individuals to live their life as healthily as possible. It becomes very essential to integrate health promotion into palliative care to accomplish levels of health. Because it is confirmed from the studies that individuals who receive significant care have a better quality of life, as well as feel fewer symptoms of depression and are more in control, and also capable of avoiding risks that are associated with treatment and hospitalization. Furthermore, promoting high-quality palliative care in clinical area can develop opportunities as well as can produce a large amount of positive impact on important priority health care areas in terms of reforming and addressing few of the significant challenges that hospitals encounter i.e.
• Improving quality
• Decreasing variation in care
• Decreasing avoidable readmissions
• Assuring the safety of the patient and develop a feeling of satisfaction among them
• Addressing overcrowding of ICU
Several leading Australian health care systems have developed palliative care programs for promoting health care practices that are attaining successful outcomes as well as improving also quality of care through dropping readmissions by using resources wisely (Health, 2020). To improve health care services, it is necessary to integrate the palliative approach based on models of healthcare delivery which will facilitate both an adaptation as well as application of palliative care expertise and knowledge in all healthcare sectors to reduce chronic life-limiting conditions. Moreover, the best practice for promoting health care services by providing training to the nurses and employees through organizing training programs and workshops. Further, guidelines must be prepared by the Ministry of Health to develop awareness on palliative care and to increase the palliative services in the hospitals.
To accomplish the better health care services, it is needed to perform a detailed research in order to determine the models of care delivery which will be most appropriate, cost-effective, and useful. This thing can be attained only if palliative care expertise and knowledge will be extended beyond a domain of a palliative specialist services by including also the complete scope of the healthcare services, as well as if providers are able to address the requirements of people and their families who have facing life-limiting conditions (WHO, 2018).
Development of Professional Development Resources to Address the Issues of Palliative Care According to National Palliative Care Standards:
According to the National Palliative Care Standards, it is essential to develop the End of Palliative/ Life Education Resource Centre to provide educational portal for nurses, physicians, chaplains, hospital administrators and many other professionals in order to create an effective palliative care program as per standards and to improve and expand the services of healthcare. As well as to address the issues associated with the Palliative Care such as financial, political, and the lack of understanding and training in a palliative care approach. This resource centre will also address the obstacles in assessing the high-quality of palliative care (Morrison, 2018).
It is found that the major problem obstructing access toward palliative care is a perception between doctors as well as many healthcare professionals i.e. palliative care is suitable only during the end stage of life, as well as that doctors also feel that all patients would react negatively, and they will lose all hope if we discuss palliative care referral with them. Conceivably this isn’t surprising: Most Australian clinicians receive very small to no training in the key skills and knowledge of the palliative care, nor palliative care teams have any exposure toward modern palliative care techniques during educational training (Hammoda Abu-Odah, 2020). Thus, this professionally developed resource centre will be able to address all the issues and provide training to overcome the problems. Further, educational training will be given to the health care employees to improve their knowledge and skills to improve care services for ill patients.
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WHO. (2018). WHO defines palliative care as the prevention and relief of suffering of adult and paediatric patients.