Palliative care in Sri Lanka
The prime objective of palliative care is relieving suffering in all stages of diseases. Palliative care encompasses both malignant and non-malignant conditions and a wide spectrum of issues that require an interdisciplinary care delivery. The Ministry of Health has identified palliative care as a priority area as it ensures the best possible quality of life for the patients with life-limiting illnesses and their families.
What is Palliative care?
The name “palliative care” derives from the term “palliate,” which means, to make less severe or intense. In health care, to palliate means to lessen the severity of the symptoms of an illness without curing or removing the underlying cause. WHO defines Palliative care as an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with a life-threatening illness? It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial, or spiritual.
Who can benefit from palliative care?
Palliative care is required for a wide range of diseases. Most people in need of palliative care have chronic diseases such as cardiovascular diseases, (38.5%) Cancer (34%), Chronic respiratory diseases (10.3%), Diabetes (4.6%). In addition, some other conditions also may require palliative care, such as kidney failure, chronic liver disease, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological disease, dementia, congenital anomalies, and drug-resistant tuberculosis.
When should we start palliative care?
Palliative care begins at the time of diagnosis of a life-threatening disease and continues throughout the disease process until death and into the family’s bereavement period. ‘Palliative care is most effective when considered early in the course of the illness. Early palliative care not only improves the quality of life for patients but also reduces unnecessary hospital admissions and nonessential use of healthcare services. In many cases, palliative care is provided when there is no reasonable expectation for a cure. However, palliative care can be given simultaneously with treatment for a chronic or life-threatening illness or injury.
What does palliative care provide?
Palliative care is holistic care. It cares not only about the physical symptoms, but also the emotional, social, and spiritual aspects of serious illness. Therefore, it offers a support system to help patients live as actively as possible until death. Palliative care emphasises:
Maximising quality of life Management of pain and other distressing symptoms
Communication among the treating physicians
Coordination of medical and supportive services and integrating the psychological and spiritual aspects of patient care.
Assistance with patient decision-making about care.
Support for caregivers.
Palliative care in Sri Lanka
The demand for palliative care in Sri Lanka also continues to grow due to the rising prevalence of non-communicable diseases and the ageing of the population. Palliative care is well-recognized and resourced as an integral component of the health system in Sri Lanka’s national policy. It is included in the National Strategic Framework for Palliative Care Development in Sri Lanka (2019-2023) and the National Strategic Plan in Prevention and Control of Cancer in Sri Lanka (2020-2024). As an early initiative in palliative care training, a certificate course in palliative care for medical officers was conducted by the institute of palliative medicine, Calicut, India (WHO Collaborating Centre in community-based palliative care and long-term care) in association with the College of General Practitioners of Sri Lanka together with the national cancer control programmer, Ministry of Health & WHO Country office Sri Lanka.
Palliative care in practice