Comfort, quality of life and relief from suffering. These are some of the goals of palliative care a specific area of medicine aimed at patients at the end of life or who are diagnosed with a disease that threatens the continuity of their existence.
Palliative care can alleviate physical, emotional, social and even spiritual impacts from the work of multidisciplinary health teams.
The episode “Palliative care: the medicine that relieves pain”, from the CNN Vital Signs won the 2022 Inter-American Press Society Journalistic Excellence Award in the health category (watch the full above ).
“It is a way of looking at the individual as a whole, understanding that there is a person there with a whole history that even precedes the illness process, and of providing care aimed at offering a better quality of life for that person and a end of life with more dignity”, explains Lucas Andrade, cardiologist and director of Clínica Florence, in Salvador.
According to intensive care and palliative physician Daniel Neves Forte, palliative care does not seek to take care of death, but of life. “People don’t want to die, they want to live well. I think that’s what palliative care is about: caring for life, and life is only life because it has death,” he says.
“The doctor focuses so much on the disease, on wanting to fix it, that he forgets about suffering. What to prioritize now? Wanting to fix it in the best of intentions can break and hurt. The patient is fragile, then comes complication after complication”.
The episode features interviews with some of the biggest names in the specialty and follows the routine of patients and family members who had access to these services.
“In the case of a patient with a lot of pain due to cancer, for example, we have many ways to alleviate the suffering in parallel with the treatment of the disease”, highlights geriatrician Ana Claudia Quintana, author of the bestseller “Death is a day that life is worth living.” “You will see a patient who is able to overcome all the adversities of treatment and achieve a much longer life span than if he had not had this care”, she adds.
Hospital do Câncer IV is the Palliative Care Unit of the National Cancer Institute (Inca), in Rio de Janeiro. The space has modalities of hospitalization and home care by the Unified Health System (SUS).
The episode shows the personal experience with the theme of Ana Cristina Pinho, director general of the institution. Ana Cristina’s husband, an anesthesiologist at the Inca, died at home receiving this type of treatment. From the diagnosis of lung cancer, in 2014, to death, it took a year. The doctor says that the treatment was attempted, but the disease progressed.
“We gave everything we could, especially a lot of love, a lot of affection, a lot of respect, a lot of dignity and even leaving him until the last moment there with us, listening to the songs he liked to hear, eating while he could. eating, eating chocolate ice cream, having the pleasure as long as possible. This is the practical application of the palliative care concept”, says Ana.
The first private unit in Brazil created exclusively for end-of-life patients is located in Salvador. At the Florence Clinic, the sisters Quézia and Rebeca experienced the loss of their mother, Maria Lícia, in 2019, due to lung cancer with metastasis in the brain. They alert to the importance of the union between conventional treatment and palliative care.
“We had a dignified farewell, a welcomed family and the pain eased”, says Quézia, who takes the book by geriatric doctor Ana Claudia Quintana from her pink bag and reads an excerpt to the team. “To be with someone who is dying, we need to know how to help the person live until the day their death arrives. Although many choose to live a dead way, everyone has the right to die alive. When it’s my turn, I want to end my life on a good note, I want to be alive on that day. And my mother was alive that day.”
“And in the ball pool”, complements her sister Rebeca. The bank teller Maria Lícia passed away on July 25, 2019, fulfilling a dream: alongside her family, friends and doctors who made it possible for her to have fun immersion in colorful plastic balls.
For philosopher Mario Sergio Cortella, also one of the interviewees in the episode, this is the universe of palliative care: when the patient is at the heart of care, in which his biography is respected and understood.
“I will use the expression of a doctor from Minas Gerais, Guimarães Rosa, the person who knows that there are times when life seems like a big sertão, but there are paths, and these paths are, on a large scale, what is up to palliative care”.
Expansion in the offer
Despite being a fundamental treatment, palliative care is still not a widespread reality with access to the Brazilian population.
According to the 2019 Atlas produced by the National Academy of Palliative Care (ANCP), Brazil has about 2,500 hospitals with more than 50 beds each, but only 5% of them have a palliative care team.
When it comes to the Hospice modality (hospice in palliative care), there are only 12 such institutions in the entire country.
The Ministry of Health and the National Council of Health Secretaries (Conass) in partnership with Hospital Sírio-Libanês are working on a national project to implement palliative care in the public network.
Between 2021 and 2023, training and implementation of protocols in the area will be carried out in a set of SUS services (a hospital, a specialty clinic and home care) in each of the 27 Brazilian states. The project was published in the Official Gazette in April 2021.
Source: CNN Brasil