30.1 Palliative care and its significance in chronic illness
Note that palliative care does not only mean the terminal care given to people dying from an incurable chronic illness.
Palliative care aims to improve the quality of life for chronically ill patients and their families, by preventing and giving relief for pain and other physical, psychosocial and spiritual problems. It is also an essential part of comprehensive HIV care and support services. Palliative care is provided for patients from the time the chronic disease is diagnosed until the end of life. It regards dying as a normal process, and affirms life. It also offers support to help the patient and family cope during the illness and in the bereavement period, the time of grief due to the loss of a loved one through death.
Palliative care is not only useful for patients with HIV/AIDS, but also for people with chronic communicable and non-communicable diseases who require long-term care at home. It is also important for people with a curable illness with symptoms that last a long period of time (e.g. many months) before they are cured.
Cancer, diabetes, heart disease and chronic lung disease are described in the Non-Communicable Diseases, Emergency Care and Mental Health Module.
Can you think of a curable chronic communicable disease whose patients may benefit from palliative care?
Treatment for tuberculosis may involve long-term care at home.
The palliative care needs of patients increase with time, particularly in a situation where the underlying disease is getting worse rather than better. In areas where patients present late for medical care, the need for palliative care is high. With good treatment and support, palliative care can help many patients live comfortably with a chronic disease for many years. For those who have advanced disease in a terminal phase, palliative care focuses on promoting quality of life by providing good symptom management. This can help patients continue to function and enjoy life at home for as long as possible.
What are the four major components of palliative care in Ethiopia?
They are: symptom management, including pain management, psychosocial and spiritual support, home-based care and end-of-life care.
Below we will discuss each of the four components of palliative care for PLHIV in detail. Remember that these components are inter-related.