Black Bata Black Art26:30What would happen if the palliative care was about living better?
Palliative care has an image problem.
Despite what people think, it is not some kind of “gloomy service”, they say two of Canada’s main experts in this field of medicine.
Ideally, it should focus on improving the quality of life of a patient when they face a “potentially mortal disease,” says Dr. Samantha winemaker, who, with researcher Hsien Seow, has the mission of changing the way patients and their doctors think about palliative care.
“I think people think that palliative care is about dying and death, and when accepting it, you are renouncing hope,” Seow told Dr. Brian Goldman, host of CBC’s Blanca Pata, black art.
But it’s not about giving up the treatment options that extended life, Seow said.
“Actually, when we break it up, it is exactly the opposite,” said Canada’s President of Research in Innovation of Palliative Care Systems and Health. “It’s about living your maximum every day and every step of the trip.”
The winemaker, a doctor at McMaster University in Hamilton, Ontario, who has specialized in palliative care at home for 20 years, is working with Seow to encourage family doctors and other health workers on how to incorporate palliative care approaches into their own practices. They are organizing a podcast, talking with professional groups around the world, and they have written a book called I hope the best, plan the rest: 7 keys to navigate a diagnosis that changes life.
And urge Canadians to seek palliative care much earlier if they face progressive disease to ensure that they have so much information and choice possible.
Information is power
Known as “Dr. Sammy” for their patients and their families, the winemaker says that being ready to have difficult conversations varies from person to person. But after taking care of thousands of people, he discovered that “having less information because we believe that we are protecting people or that we still do not want it, it will result in a family to have a more internal disease experience,” with their choices that become “very reactive and driven by the crisis.”
Seaw says that numerous studies have found that Patients and families want doctors to be more initial About his forecasts.
“They want to know what to expect in the future. They want to plan in advance,” said Seow, who is also a professor in the Oncology Department of McMaster University. “However, there are also Research that says people do not want to prepare for their death. Therefore, there is this balance between walking two paths, which expects the best but planning for the rest. “
Listening | Why are palliative care not only for patients
Black Bata Black Art26:30Palliative care is not just for patients, it is for families
Blanca Pata, Black Art Accompanied the winemaker, who is also an associated professor in the Palliative Care Division of the Department of Family Medicine of McMaster, in a visit to the house of Ken Hajas, who recently diagnosed prostate cancer in stage 4.
The winemaker asked him how he was adapting to the news.
“I guess I am adjusting, but until now, I am comfortable, that’s all. What happens will happen, and I am willing to accept it,” said Hajas, pointing out, however, that he will do everything possible to prolong his life.
Winemaker says that he enters those first meetings to try to meet the patient and his family, to find out how much information they have about palliative care and what could be ready to receive.
Hajas said he hasn’t asked how long it has left.
“I will ask that question later, maybe. But at this time I feel so good that it seems redundant,” he said.
But his wife, Kathy Hajas, and his daughter Sue Barker want a better idea of his life expectancy, and he gave his permission for the winemaker to have those discussions with them.
“I think for mom and me, and maybe my sisters, I think it’s better to face if you know more information and have time to digest it,” said Barker. “The worst part of this trip, just for me personally, has been not knowing.”
‘We feel swampy’
When Shelley McCarthy and his family were dealing for the first time with their diagnosis of stadium 4 thyroid cancer in 2018, four years before dying, they had an overwhelming number of health workers to navigate and information to digest.
McCarthy’s care involved a head and neck surgeon, oncologist radiation, medical oncologist, neurologist and family doctor, said the winemaker. “And she had an orthopedic team because her thyroid cancer was also in her bones.”
Although everyone in the family had the advantage of a good education, “we felt flooded,” said McCarthy’s husband, Terry, in a recent interview.
The experience left the family feeling that the medical care system was fragmented and compartmentalized, with “a lot of emphasis on physical care … but not enough in communication and support,” he said.
That changed when McCarthy was referred to winemaker and registered nurse Jenn Morrit, who provides care in patients’ homes.
McCarthy’s eldest daughter, Tara Kerr, said she was initially alarmed when she learned that her parents had established an appointment with a palliative care team as soon after having understood that her mother’s diagnosis was terminal.
“I remember thinking, ‘What are we doing in the world? This is too soon.’ But no, it was exactly what we needed,” Kerr said. And I am very, very grateful that we had them from the beginning … that open environment, that ability to talk about those difficult things and ask the questions … really reassured us. ”
Limited access
Although access to palliative care in Canada is limited, it is also improving. TO Report 2023 of the Canadian Health Information Institute (Cihi) found that 58 percent of Canadians who died in 2021-2022 received palliative care compared to 52 percent in 2016-2017. But despite the desire of most people to spend their last days at home, only 13 percent received palliative care at home, the kind winemaker and his team provide, in 2021-2022.
Cihi’s report cited a variety of barriers to receive palliative care, particularly in an environment at home, including age: people over 65 to 84 years at the time of death were the group most likely to receive palliative care, while those over 85 were less. Other factors included limited access in rural areas and country of origin, and those born outside Canada are less likely to be referred to palliative care, just like those whose disease is another thing other than cancer.
One of the other barriers, said the winemaker, is the lack of education for doctors about palliative care.
“There is absolutely no mandatory curriculum throughout the country in medical training and palliative care,” he said. “And if it exists, it is very irregular.”
But the shortage of palliative care is not just a problem in Canada. A study published this week in Lancet Global Health found that almost 74 million people need palliative care worldwide, a 74 percent increase in three decades.
However, where investments in palliative care have been made, they have shown that they bring good yields, Seaw said. “There are tons and tons of random studies that show that Palliative care leads to better patient resultsas less burden of symptoms, more satisfaction and in fact, It also saves money to the health system avoiding unnecessary visits from the hospital“
Fortunately, improving access does not depend on training more specialists in palliative care, said the winemaker.
“I think every cardiologist, virologist, nephrologist, hepatologist, neurologist, oncologist, family practice [physician]We all have a participation in the game and we must all provide a palliative approach.
“In the future, personally, I hope that nobody needs us because we have done such a good job by integrating a palliative philosophy of attention in all care providers.
