01.09.2014 "No longer exhaust every practical possibility, but focus on the patient's peace of mind"
Palliative care/publication. The term "palliative care" is used when the focus of treatment is no longer on cure or life-prolonging measures, but on alleviation of suffering and on the patient's quality of life. Palliative care is playing an increasingly important role in care of the ageing. A brochure is available that provides a touching portrait of this approach in practice, with sensitive contributions from patients and health professionals.
"It's all about relieving the patient's suffering. It's important to talk with everyone concerned. Talk, talk and talk again. And it's important to make generous use of morphine in the terminal phase." This is how Balz Briner, GP at the "Am Wasserturm" home for the elderly in Basel, views palliative care. Briner features prominently in the brochure "Menschen am Lebensende begleiten" (Supporting people at the end of their lives), published by the Curaviva association of Swiss care homes and the Federal Office of Public Health. The authors Cornelia Kazis (German version) and Anne-Marie Nicole (French version) give a precise and touching account of palliative care through portraits and reports concerning people who directly experience this approach in a care facility for the elderly. The resulting stories describes what is in people's minds as their life moves towards its close. And they show how patients are treated and looked after in accordance with the basic principles of palliative care.
As adapted from the WHO definition, palliative care is "the active, integrated treatment of patients with a progressive, advanced disease and limited life expectancy at a time when the disease no longer responds to curative treatment and top priority is given to the management of pain, other symptoms and psychological, social and spiritual problems". What this can, and does, mean in actual practice is vividly described in the brochure through stories from the everyday care of elderly patients. Contributions come from a wide range of different people – for instance, two care home residents, Frau Schwab and Madame Lutz. But the authors also shadowed the professionals at their work of treating and caring for the patients – nurses, the director, pastors, GPs and voluntary workers. And even people such as Nghia Thai, who works in the kitchen, or Ornella Francolini, whose mother is a resident, tell their stories in the brochure. They are all able to help make the final stage in the patients' lives as agreeable as possible and to alleviate their suffering as much as possible. That is the essence of palliative care. "Palliative" stems from the Latin verb palliare, "to cloak", and pallium, "coat". As such, palliative care also means that personal wishes and preferences with regard to food and drink, for instance, or, in the context of care, the patient's life history, are taken into account.
Increasingly important in care of the ageing
Palliative care has its origins in cancer medicine. But the demographic development has been such that it now plays a key role particularly in care of the ageing. Growing numbers of people now live to an advanced or very advanced age, with all the associated infirmities, disturbances and diseases. In these patients, cure is no longer the goal. In care homes for the elderly, the high-tech equipment of acute care is relegated to the background. According to Balz Briner, it is "an opportunity to no longer exhaust every practical possibility, but focus on the peace of mind of the elderly people who live here". It is therefore all the more important for nursing homes and the general public to be familiar with the possibilities of palliative care. The new brochure is an introduction to this approach that is not only informative but also inspiring and touching.
The brochure "Menschen am Lebensende begleiten. Geschichten zu Palliative Care in Alters- und Pflegeinstitutionen" [Supporting people at the end of their lives. Stories about palliative care in homes and services for the ageing] is available in a German and a French version. Download at: www.bag.admin.ch/palliativecare or http://www.curaviva.ch/Fachinformationen/Themendossiers/PQBbv/?method=dossier.detail&id=4E2D11BA-E9A6-EA4F-ECD14AB433B656B0.
Printed version available free of charge at https://www.bundespublikationen.admin.ch/cshop_bbl/bp/updateItems/%28cpgnum=1&layout=7.01-13_125_68_76_6_127_2&cquery=*316.723*&uiarea=2&carea=%24ROOT&cpgsize=10%29/.do?next=seeItem&itemkey=0024817F68691EE1B4AF29EBB8348F02E83935BF45E31EE389BA2F28B67D0DC6&areakey=0024817F68691EE1B4AF29EBB8348F02&lastVisited=catalogQuery&isProductList=&itemPageSize=10&page=1&display_scenario=query&isQuery=yes&detailScenario=&xsrfid=fnbC08e6155I3D5v0OI5_aDsLAs5QVYS0wk.
Lea von Wartburg, Palliative Care Project Manager, National Health Policy Section, firstname.lastname@example.org