In the middle of the debate following the adoption of the Euthanasia Law, many physicians have demanded that expand resources for palliative careconsidering that they do not have the necessary means to adequately attend to the patients who require it.
Juana Sánchez, head of the pain and palliative work group of the Spanish Society of General and Family Physicians (SEMG), explains to Medical Writing what is Primary Care who should care for these patients. “The place of palliative care, as long as it can be guaranteed, is the patient’s home and, therefore, it is the family doctor —supported by the support teams— who must take care of it.”
However, ” the lack of existing HR, plus the pandemic, has made it more complex to devote all the time that palliative patients require. Family doctors do not arrive and support teams are saturated“, Juana Sánchez explains to this newspaper. “We cannot be at home every day, but there must be coordination between family doctors and support teams of home care to meet the needs of each patient, which are different depending on the type of disease that each of them has”.
The current problems are” mainly ” lack of resources. “Existing resources are not enough, not only the personnel but also the materials. In rural areas the distances are longer, the hospitals are not close and the patient cannot be sent to the hospital every two days. We have to give an adequate response, that’s why we need good coordination, also with those who are on guard,” he says.
Palliative patients want to be treated at home
Palliative care, which can sometimes extend over time according to the evolution of each disease, therefore, it requires not only the intervention of the family doctor, but it is “essential”, according to Juana Sánchez, the coordination with the support team.
The doctor explains that the patient’s wishes must first be taken into account. “Palliative patients want to be treated at home, where they are cared for by their families, so you have to ensure that you can give an answer 24 hours. Although it is complex, they must be attended by Primary Care coordinated with home care support teams.”
Primary care and support teams organize palliative care
Daniel Ramos, a specialist in this area, agrees with Juana Sánchez and asks to work on a model for palliative care in Primary Care with a greater number of resources. “Without a solid Primary Care model there is no hospital care! The model will fall by its weight! Without Primary Care, palliative care support teams have no reason to be! For a quality model!”.
In statements to Medical Writing, Daniel Ramos explains that ” there is no point in home support teams in palliative care if there is no a Primary Care model to whom to give support in an organized way and with criteria of complexity”.
Palliative care should make them any sanitary
In his opinion, he believes that without the support of Primary Care “we would not cope with the number of patients or the dispersion that exists in some communities, such as in Castilla y León. Palliative care should be done any sanitary what’s in front of you a patient in need, everything will depend on your training and experience”
The expert in palliative care says to this newspaper that this care from Primary will require support from ” human resources, as well as stabilizing the teams, reducing quotas in some places, train well those who need to attend palliative care, organize attendance and coordinate resources well“.
Palliative care requires home visits and “you have to have time, each patient needs a certain time“, explains Daniel Ramos to Medical Writing. Therefore, palliative care in Primary Care must be done in a ” comprehensive and coordinated manner. They might be done more clinical sessions, sharing care in a more organized way. Specialized teams would focus on high complexity, ” he concludes.
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