2023-09-17 19:21:29
Definition: what does palliative care mean?
THE palliative care correspond to all treatments aimed at improving the quality of life of patients and their families, faced with a serious, potentially fatal chronic illness. They are part of supportive care.
More concretely, it is a real therapeutic arsenal that is available to the patient and their loved ones. Both doctors and other health professionals (physiotherapists, psychologists, occupational therapists, etc.). This care aims to protect the patient from both physical and psychological suffering. Doctor Ilan Darmon, oncologist and radiotherapist.
Palliative care can be provided in a health establishment, in a medico-social establishment or at the patient’s home under certain conditions and by decision of the medical profession.
The right to access to palliative care has been enshrined in law since April 22, 2005 (the so-called “Leonetti” law) in article L 1110-5 et seq. of the Public Health Code.
The average age in palliative care is 60 ans.
What is the difference between palliative care and end of life?
The palliative approach should not be confused with the end of life. In fact, palliative care is not an accompaniment towards death in the best conditions.
Even if palliative care is not intended to cure the patient, some patients emerge from these treatments in better physical and moral shape than before their arrival. Doctor Ilan Darmon, oncologist and radiotherapist.
According to article L 1110-10 of the Public Health Code, palliative care aims “to relieve pain, to soothe psychological suffering, to safeguard the dignity of the sick person and to support those around them”.
Nevertheless, it is true that the law provides that this care “must not be pursued through unreasonable obstinacy. When it appears useless, disproportionate or having no other effect than the sole artificial maintenance of life, it can be suspended or not undertaken” (article L 1110-5 of the Public Health Code). We then talk regardingtherapeutic relentlessness. In this case only, the law authorizes the use of passive euthanasia, that is to say the refusal or cessation of treatment necessary to maintain life. The case law also admits indirect euthanasia, that is to say the possibility of administering to the patient analgesics intended to relieve their suffering even if they have the effect of causing death. The patient or a trusted person or, failing that, a close relative must be informed.
Why put a person in palliative care?
Palliative care is aimed at any patient suffering from a chronic, potentially fatal illness, regardless of their age. Palliative care can be offered to adults, adolescents and children.
This medical care must be accessible as part of the patient’s care pathway, and discussed as early as possible so as to anticipate it so that, at the appropriate time, it can be implemented to complement or replace curative care.
How does palliative care work?
Palliative care can be implemented in a health establishment as well as in a medico-social establishment (such as an EPHAD) or even at the patient’s home.
Generally, this medical care is orchestrated by a general practitioner who specializes in palliative care. He administers pain medication and works in a network with other doctors and health professionals who may be involved in the treatment (palliative care network). He is also in contact with the patient’s family and loved ones. Doctor Ilan Darmon, oncologist and radiotherapist.
Palliative care at home
Some patients wish to stay at home during their treatment. In this case, the implementation of curative and palliative treatments at home may be accepted by the medical team.
The sick person must then be supervised by their loved ones. She is followed by a doctor specializing in palliative care or the usual attending physician who has a coordinating role. He organizes follow-up with local health professionals who come to the patient’s home. Nurses, care assistants and sometimes support volunteers are also offered to ensure support for caregivers and continuity of care. Psychosocial support for the patient and their loved ones is guaranteed (psychologists, psychiatrists, social workers, etc.).
If the situation becomes more complex, the usual health professionals can call on mobile palliative care teams. A home hospitalization (HAD) can also be implemented.
Palliative care in health establishments
Sometimes hospitalization is absolutely necessary. In this case, palliative care is provided in a hospital environment in the department that usually takes care of the patient (for example, the oncology or cardiology department depending on the pathology being treated).
These services may involve a mobile palliative care team. The person can also be cared for in a bed specially dedicated to palliative care even in a palliative care unit (USP).
Palliative care can also be practiced in a medical-social establishment (like a EPHAD) or in any other type of structure as long as this care is personalized and orchestrated by an involved doctor. Family and loved ones are always contacted during treatments.
Can we leave palliative care?
The average duration of palliative care is 18 days. If most patients are not cured upon leaving this acute care, some can return to their initial service while others return to their home or a medico-social establishment.
For their part, the end-of-life patients have rights in decisions regarding their medical care. Leaving palliative care is a possible option for them, under certain conditions. Any exit is subject to a decision which depends on the opinion of the attending physician, following consultation with the medical team.
1695033963
#Palliative #care #work