WHO's guide on palliative care

Palliative care is for any terminal illness, but often seems to focus on cancer. This is likely because this is the disease with which most of us are familiar. The important thing to take away from the discussion about palliative care is that it almost always is also applicable to other terminal illnesses. While certain symptoms or physical issues may be different, there are more similarities than differences when it comes to end-of-life care.

This month, the World Health Organization (WHO) has published a new guide on palliative care for those who are dying of cancer in the developing nations. You can find a copy of this guide at the WHO website. On page 2, you will find the Key Messages:

“Palliative care is an urgent humanitarian need worldwide
for people with cancer and other chronic fatal diseases.
Palliative care is particularly needed in places where a
high proportion of patients present in advanced stages
and there is little chance of cure.

Ideally, palliative care services should be provided from
the time of diagnosis of life-threatening illness, adapting
to the increasing needs of cancer patients and their
families as the disease progresses into the terminal
phase. They should also provide support to families in
their bereavement.

Effective palliative care services are integrated into the
existing health system at all levels of care, especially
community and home-based care. They involve the
public and the private sector and are adapted to the
specifi c cultural, social and economic setting.

In order to respond to the cancer priority needs in a
community and make the best use of scarce resources,
palliative care services should be strategically linked to
cancer prevention, early detection and treatment services
for both adults and children.”

The guide is very interesting reading and I encourage anyone who is interested in the institution of palliative care in the developing world to read it. The authors review the social context of palliative care plan, gaps in services, assessment of the feasibility of services, priorities, planning, and organization.

Saturday, October 6, 2007: World Hospice & Palliative Care Day.

What is World Hospice & Palliative Care Day? According to their website, “World Hospice and Palliative Care Day is a unified day of action to celebrate and support hospice and palliative care around the world.

World Hospice and Palliative Care Day will take place on October 6th 2007 with Voices for Hospices, the global musical marathon event which has over 500 concerts around the world and is the official fundraising event for World Hospice and Palliative Care Day 2007."

Among the people who know me, it’s no secret that I have a strong interest in death and dying, and the end-of-life stages. I recall taking a humanities class in college called Death and Dying, although truth be told, I can’t recall anything of what I learned. But it must be that the class sparked my interest because even when I was working in the acute care hospitals, I felt like I could make a difference with my patients who we knew were going to die.

To that end, I’ve started my own site on Palliative Care. I invite people to look at it and use it for the resource that I hope it will be. It’s definitely in its infancy and I’m hoping that it becomes as useful a tool as I think it could be. If it does, I’ll move it to its own domain and see how large it can grow.


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Advanced directives/Living wills

Post 100! When I began writing this blog, I wasn’t sure if it would last a week, let alone for 100 posts. Where’s my cake? {grin}.

Ok, now for the stuff that people come for:

How many of you have advanced directives or a living will? If you don’t have one, have you thought about one?

I’m working on a proposal for a potential client and one part includes information on advanced directives, what’s involved and why people should have them. I don’t have one on paper, although I have discussed this with family and friends. Considering my work as a nurse, after seeing what I have seen, you would think that I would have it more together and have my wishes written out, but I am like millions of other North Americans and just haven’t gotten around to doing it.

What are advanced directives? An advanced directive or living will is an important document that relays your wishes for health or medical care if you are unable to speak for yourself or if you are unable to make such decisions. If you don’t have an advanced directive, family or friends may be forced into the position of choosing for you. Even if you have discussed this issue with them before, it is still a difficult decision for another person to make. By having a living will, you keep others from having to take on the burden.

Advanced directives may sometimes be called DNRs or Do Not Resuscitate orders, but a DNR order is more specific than an advanced directive. DNR means simply that: no CPR (cardiopulmonary resuscitation). A living will addresses more than just CPR. It addresses issues like if you should be placed on a ventilator if you can’t breathe, if you should be tube fed if you can’t eat, if you should be treated for illnesses other than the one causing your incapacity, and so on. An advanced directive tells the healthcare professionals how much you want done. It can even include if you wish to have your organs donated for transplantation.

When having an advanced directive or living will drawn up, check with your state or provincial laws to see what is required. If your document isn’t legally sound, first responders and other healthcare professionals cannot abide by it and must, legally, try to save your life.

Once you have made your advanced directives, make sure that the important people in your life have a copy. The document won’t be of any use if no-one knows about it or doesn’t have access to it. Be sure to review them regularly. Situations change and people change; how you feel when you write the initial document may not be the same as a year later.

And please, if you haven’t considered being an organ donor, think about it. So many lives can be saved by just one person.

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