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Sunday, 22nd October 2017
The WHO approach

APCA subscribes to the World Health Organisation (WHO) 2002 definition of palliative care for both adults and children.

Under this definition, palliative care:

  • provides relief from pain and other distressing symptoms
  • affirms life and regards dying as a normal process
  • intends neither to hasten or postpone death
  • integrates the psychological and spiritual aspects of patient care
  • offers a support system to help patients live as actively as possible until death
  • offers a support system to help the family cope during the patient's illness and in their own bereavement
  • uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated
  • will enhance quality of life, and may also positively influence the course of an illness
  • is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

The WHO summarises palliative care as:
…an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

Children's palliative care
The WHO also defines palliative care for children and their families as a special field, albeit one closely related to adult palliative care. This is particularly important in Africa, where so many children are infected and affected by HIV/AIDS:

  • Palliative care for children is the active total care of the child's body, mind and spirit, and also involves giving support to the family
  • It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease
  • Health providers must evaluate and alleviate a child's physical, psychological, and social distress
  • Effective palliative care requires a broad multidisciplinary approach that includes the family and makes use of available community resources; it can be successfully implemented even if resources are limited
  • It can be provided in specialist care facilities, in community health centres or in children's homes.

This kind of care can make an enormous difference. In 2012, the WHO and WHPCA estimated that over 40 million people needed palliative care especially at the end of life and a very small proportion was being reached.