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International Association for Hospice & Palliative Care
Advancing Hospice and Palliative Care Worldwide

This certifies that

KULJINDER BEHGAL

is a member of IAHPC and through this membership supports
the advancement of hospice and palliative care in the world.

What is palliative care?

When a patient is seriously ill with advanced stages of
Amyotrophic Lateral Sclerosis , Alzheimer’s Disease , Bone Marrow Transplant
Cancer, Chronic Obstructive Pulmonary Disease (COPD) Congestive Heart FailureCOVID-19
Dementia Eosinophil Associated Disease (EAD) HIV/AIDS Huntington’s Disease Kidney disease
Multiple Myeloma Multiple Sclerosis Parkinson's Disease Pulmonary
Fibrosis Sickle Cell Anemia and Stroke among so many other debilitating and serious diseases
. they typically choose to work with their doctors in hopes of a cure or prolonged
management of their symptoms to extend their life. These patients may also choose
to receive palliative care as a comfort measure to relieve pain or side effects of their
curative treatments to improve the overall quality of their lives.

Why Is Palliative Care Important?

In today’s society, people are living longer than ever — even those facing serious
chronic illnesses can often enjoy a much longer lifespan than past generations
thanks to advancement in the treatment of diseases including cancer, heart disease,
diabetes, and COPD. While doctors may be successful in giving their patients a
longer life, both the disease and the treatment can cause pain and other side effects.

Palliative care is important because it gives patients an option for pain and symptom
management and higher quality of life while still pursuing curative measures. When a
the patient is seriously ill, they understand the value of each day. While they still must
face their illness, the support of palliative care in controlling pain and other
symptoms can make each day a more positive experience that allows the patient to
make the most of the time they have with their families.

Hospice care and palliative care are both synonymous with comfort, but there are
important differences. Understanding these differences and understanding the
importance of palliative care will ensure the seriously ill receive the right level of care
at the right time so they can make the most of each day they have.

A Good example of why palliative care is important is a cancer patient who elects to
pursue chemotherapy and/or radiation as a curative treatment. While this treatment
is often effective at shrinking or destroying cancer cells, it has a wide range of:
effects including nausea, loss of appetite, skin burns, dry mouth, fatigue,
constipation.improves the patient's overall quality of life which is Addressing these side
effects
t to consider whenever a patient receives a diagnosis why palliative care is important
of serious or chronic illness.are receive visits from a nurse practitioner and a Patients
who begin palliative c‘o work alongside their regular physicians to monitor palliative care
social worker wht
their plan of care.

How is palliative care different from hospice care? HOSPICE care also seeks to
provide pain relief and symptom management in patients, but patients are only
eligible to receive hospice care once they have received a prognosis .

At this point, a patient can transition from palliative care to hospice care. As the
patient's illness progresses to the terminal stage, the level of care required
increases. Hospice care provides a full team of support for the patient including a
nurse, hospice aide, social worker, bereavement specialist, and volunteers.

Patients who have been diagnosed with a serious or terminal illness should speak
with their healthcare provider about what palliative or hospice care options are
available at the current point in their ieeasy progression. Even if the patient is not
yet ready for palliative or hospice care) becoming educated about the options will
help them take an active role in planning for the future.

WHO take steps to address glaring shortage of quality palliative care services

Worldwide, it is estimated only 4 in 10 people who need palliative care are receiving it and
global
“demand for care for people with life threatening illnesses will continue to grow as
populations age and the burden of noncommunicable diseases rises. By 2060, the need for
palliative care is
expected to nearly double.

The world therefore needs urgent and concerted action to scale up access to quality
palliative
care services. To address this need, WHO is releasing two new resources to support countries
in assessing the development of palliative care and improving the quality of palliative care
services.

The two resources are being released in advance of World Hospice and Palliative Care Day on
9 October 2021.

They include a WHO technical report providing a globally applicable and robust set of
palliative
care indicators for countries. These indicators can be used to assess and monitor the
provision of palliative care services in countries worldwide. The report aims to create a
global consensus on indicators to measure palliative care development and its use will
provide reliable data to support decision-making by informing health priorities and resource
allocation.

The second resource is a technical brief on quality health services and palliative care,
looking at
practical approaches and resources to support policy, strategy, and practice. The brief will
guide
action at the national, district and point of care to improve the quality of palliative care
services.
To date, monitoring the existence and maturity of palliative care services has most often
been done by assessing the consumption of opioid analgesics Although opioids are vital for
pain relief they are only one component required for the development of optimal palliative
care services.

At a global level, harmonizing data across countries provides a clear picture of global
needs and challenges in palliative care, such as inequity. Measurement is also a starting
point for identifying success stories and learning from countries to design effective
improvement strategies for application in other settings. The indicator will assist all
those working in palliative care to identify tangible steps that can be considered by
countries to expand access to quality palliative care for those who need it.

The provision of palliative care in most countries lags far behind the need for these
essential services. Each year, it is estimated over 56.8 million people, including 25.7
million in the last year of life, are in need of palliative care, of whom 8% live in low-and
middle-income countries.

COVID-19 has highlighted the need for palliative care in all places and settings to relieve
suffering at the end of life such as the physical suffering caused by breathlessness or the
mental pain resulting from separation from loved ones. The pandemic also reminds us of the
need for all health professionals to have some training in a palliative care approach: the
need for all health professionals to have some training in palliative services exceeds what
can be provided by specialist teams alone.

palliative care improves the lives of patients and their families who face the challenges
associated with life-threatening illness and serious health-related suffering including, but
not limited to end-of -life care. Optimal palliative care in countries requires: a
supportive policy environment, empowered communities, palliative care research, access to
essential palliative care medicines, strong education and training system for palliative
care workers and professionals, and attention to the quality of palliative care services.
Palliative care is a human right and moral imperative of all health systems.

Implementing world health assembly resolution on palliative care

The topic of this year's world hospice and palliative care day was ” leave one behind: Equity
in access to palliative care ”. This is an urgent and important message as the provision of
palliative care in most countries lags far behind the need for these essential services.
Each year, it is estimated over 56.8 million people, including 25.7 million in the last year
of life, are in need of palliative care, of whom 78% live in low-and-middle-income
countries. However, it is estimated that only about 12% of people needing palliative care
receive this care.

Who continues to work to support countries in the implementation of the 2014 World Health
Assembly (WHA) Resolution 67.19 on Palliative care which states the provision of palliative
care is a moral imperative of the health system and it should be integrated into all levels
of health care. On 5 October 2021, ahead of the opening of the world congress on palliative
care hosted by the European Association of palliative care, WHO hosted an online workshop
exploring the implementation of the WHA resolution to date. Palliative care specialists from
different countries described the successes and challenges of expanding access to quality
palliative care, thinking through key elements relating to children, essential medicines,
and communities.

As WHO continues to support member states in the implementation of the WHA resolution, two
new technical resources have been released which focus on expanding access to quality
palliative care. The first of these is a report on assessing the development of Palliative
Care worldwide: a set of actionable indicators. To date, monitoring the existence and
maturity of palliative care service has most often been done by assessing the consumption of
opioid analgesics. Although opioids are vital for pain relief in palliative care, they are
only one component required for the development of a robust palliative care system.

This new WHO resource provides a globally applicable and robust set of palliative care
indicators to Member States that can be used to assess and monitor the provision of
palliative care services in countries worldwide. Reliable data derived from these indicators
can support decision-making by informing health priorities, resource allocation and Ongoing
palliative care strengthening activities.

The second resource released by WHO on 5 October 2021 supports policy makers through to
practitioners to take action to strengthen the quality of palliative care services delivered
to
patients. Quality health services and Palliative Care supports action across all domains of
quality, i.e., effectiveness, Safety, people-centredness, timeliness, equity, integration
and efficiency. It describes approaches to quality policy, strategy and planning for
palliative care programmes and services, presents learning on quality of care arising from
palliative care programmes, and offers considerations on measurement of quality palliative
care services at all levels of the health System

Quality and palliative care are both embedded at the heart of Universal Health Coverage
(UHC),
without concerted action on quality palliative care, the achievement of UHC is at risk.
These
WHO resources will support countries in their journey of providing quality palliative care
UHC, alongside other important WHO resources such as the UHC compendium. The
engi now contains a detailed package of palliative care services which can be utilized at
fel to develop an essential package of services required to meet palliative care needs.
the UHC compendium, users will also find palliative care linked to multiple other
immes to support an integrated approach to palliative care service delivery,
ugh primary healthcare services.

As described above, currently only 12% of Palliative care needs are being met worldwide.

WHO will continue to work tirelessly with member states to address this gap in provision and
ensure concerted action is taken on expanding access to quality palliative care to ensure no
one is left behind.

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