- Who needs palliative care
- What is the difference between palliative care and euthanasia?
- How to receive palliative care
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 relieving their suffering, improving their well-being. being and quality of life.
The types of care that can be involved are:
- Physical: used to treat physical symptoms that can be uncomfortable, such as pain, shortness of breath, vomiting, weakness or insomnia, for example; Psychological: take care of feelings and other negative psychological symptoms, such as anguish or sadness; Social: offer support in the management of conflicts or social obstacles, which can impair care, such as the lack of someone to provide care; Spiritual: recognize and support in relation to issues such as offering religious assistance or guidance in relation to the meaning of life and death.
All this care cannot be offered only by the doctor, it is necessary that there is a team composed of doctors, nurses, psychologists, social workers and several other professionals such as physical therapists, 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, this type of care should, ideally, be available in general hospitals, outpatient consultations and even at home.
Who needs palliative care
Palliative care is indicated for all people who suffer from a life-threatening illness that worsens over time, and is also known as a terminal illness.
Thus, it is not true that this care is performed when there is no longer "nothing to do", as essential care can still be offered for the well-being and quality of life of the person, regardless of their life span.
Some examples of situations in which palliative care is applied, whether 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, lung disease, liver disease, among others; 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 relatives of people who suffer from these diseases, by offering support in relation to how care should be taken, the resolution of social difficulties and for a better elaboration of mourning, as situations such as dedicating oneself to caring for someone or dealing with the possibility of losing a loved one is difficult and can cause a lot of suffering in family members.
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, orthothanasia and dysthanasia.
Thus, despite not approving euthanasia, palliative care also does not support the practice of treatments considered futile, that is, those that only intend to prolong a person's life, but that will not cure it, causing pain and invasion privacy.
How to receive palliative care
Palliative care is indicated by the doctor, however, to ensure that it is done when the time comes, it is important to talk to the medical team that accompanies the patient and show their interest in this type of care. Thus, clear and frank communication between the patient, family and doctors about the diagnosis and treatment options for any disease is very important to define these issues.
There are ways of documenting these desires, through documents called "Advance directives of will", that allow the person to inform their doctors, about health care that they want, or that they do not want to receive, in case, for any reason, they find themselves unable to express treatment wishes.
Thus, the Federal Council of Medicine advises that the registration of the advance directive of will can be done by the physician accompanying the patient, in his medical record or in the medical record, as long as expressly authorized, without witnesses or signatures being required, as the doctor, by his profession, he has public faith and his acts have legal and juridical effect.
It is also possible to write and register in a notary public a document, called Vital Testament, in which the person can declare these wishes, specifying, for example, the desire not to be subjected to procedures such as the use of breathing apparatus, feeding on tubes or passing by a cardio-pulmonary resuscitation procedure, for example. In this document it is also possible to indicate a person of confidence to make decisions about the direction of treatment when he can no longer make his choices.
