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International Pain School
Palliative Care
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What is Palliative Care?
WHO definition of palliative care
• Active total care of the patient…
• Begins at diagnosis, and continues regardless of whether
or not a patient receives treatment directed
at the disease
• Health providers must evaluate and alleviate a child's
physical, psychological, and social distress
• Requires a broad interdisciplinary approach
What is Palliative Care?
“The art and science of patient and family-centered care
aimed at attending to suffering, promoting healing and
improving quality of life”
The goal is to add life to the patient’s years, not simply years
to the their life …
Why is it so important?
• We cannot cure or save everyone and we will
all die someday.
• When resources are limited or unavailable,
every patient should have the benefit of symptom
management, especially at the end of life.
• Opioids should be available for all patients to
help alleviate pain and suffering, although not
currently the case.
• Palliative care and symptom management does not
require high-tech medicine, but may be achieved
anywhere with education and dedication.
Aspects of Palliative Care
• Provide comfort
• Foster interpersonal relationships
• Emotional support
• Social support
• Spiritual support
• Bereavement care
Totality of Personhood
Religion
Culture
Body
Mind
Spirit
Society
Education
Goal: to attend to suffering, of any kind, and improve quality of life
Barriers to High Quality Palliative Care
• Personal
– Emotionally difficult, taboos, resisting change
• System
– Access to services, reimbursement, fragmentation
• Quality
– Deficient education, lack of outcomes research
• Technical
– Lack of appropriate evaluation tools
Integration of Palliative Care
• Palliative care can be a part of symptom management
from the time of diagnosis
• When there are no curative options, focus medications and
treatments on comfort only
• Dosing of pain medication, such as opioids, has no upper
limit-especially at then end of life
• Treat all aspects of the patient as their greatest suffering
may not be from physical pai
Remember
• Palliative Care and symptom management only requires
attention to what the patient needs, regular re-assessment,
and access to medication.
• High-quality palliative care does not require any high-tech
materials or equipment
• Everyone can provide palliative care to those in need,
especially at the end of life
This talk was originally prepared by:
Jamie Laubisch MD & Justin Baker MD
Memphis, USA
International Pain School
Talks in the International Pain School include the following:
Physiology and pathophysiology of pain
Nilesh Patel, PhD, Kenya
Assessment of pain & taking a pain history
Yohannes Woubished, M.D, Addis Ababa,
Ethiopia
Clinical pharmacology of analgesics
and non-pharmacological treatments
Ramani Vijayan, M.D. Kuala Lumpur, Malaysia
Postoperative – low technology treatment methods
Dominique Fletcher, M.D, Garches & Xavier
Lassalle, RN, MSF, Paris, France
Postoperative– high treatment technology methods
Narinder Rawal, M.D. PhD, FRCA(Hon),
Orebro, Sweden
Cancer pain– low technology treatment methods
Barbara Kleinmann, MD, Freiburg, Germany
Cancer pain– high technology treatment methods
Jamie Laubisch MD, Justin Baker MD, Doralina
Anghelescu MD, Memphis, USA
Palliative Care
Jamie Laubisch MD, Justin Baker MD,
Memphis, USA
Neuropathic pain - low technology treatment methods
Maija Haanpää, MD, Helsinki & Aki Hietaharju,
Tampere, Finland
Neuropathic pain – high technology treatment methods
Maija Haanpää, M.D., Helsinki & Aki Hietaharju,
M.D., Tampere, Finland
Psychological aspects of managing pain
Etleva Gjoni, Germany
Special Management Challenges
Debra Gordon, RN, DNP, FAAN, Seattle, USA
International Pain School
The project is supported by these organizations:
International Pain School
More lectures and further information can be found on our project website.
www.international-pain-school.org
© 2013 international-pain-school.org